Laparoscopic cholecystectomy for biliary dyskinesia in children provides durable symptom relief.
OBJECTIVE
The purpose of this study was to determine the effectiveness of laparoscopic cholecystectomy in children with biliary dyskinesia.


METHODS
Reports of children with an abnormal cholecystokinin (CCK)-stimulated HIDA scan between January 2001 and July 2006 who underwent laparoscopic cholecystectomy were reviewed. Postoperatively, a 23-item Likert scale, symptom questionnaire was administered to parents.


RESULTS
Sixty-four children with chronic abdominal pain and no gallstones on ultrasound had an abnormal CCK-HIDA scan. Twenty-three children (median age, 14 years; 16 girls), with mean (SD) ejection fraction of 17% (8), underwent laparoscopic cholecystectomy and were further analyzed. Preoperatively, these children had right upper quadrant/epigastric pain (78%), nausea (52%), vomiting (43%), and generalized abdominal pain (22%) lasting for a median of 3 months (range, 1 month to 2.5 years). Median postoperative follow-up was 2.7 years. Sixteen (70%) parents completed the questionnaire. Of those who responded, 63% indicated that their children had no abdominal pain, 87% had no vomiting, and 69% had no nausea in the month preceding the questionnaire. Overall, 67% of parents indicated that their children's symptoms were completely relieved after cholecystectomy, whereas 7% indicated that the symptoms were not relieved.


CONCLUSIONS
Laparoscopic cholecystectomy is effective in providing both short-term and long-term improvement of symptoms in children with biliary dyskinesia.
Department of Surgery, Division of Pediatric Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Ramanath N
RN
Haricharan
Lyudmila V
LV
Proklova
Charles J
CJ
Aprahamian
Traci L
TL
Morgan
Carroll M
CM
Harmon
Douglas C
DC
Barnhart
Shehzad A
SA
Saeed
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000293:Adolescent; D001657:Biliary Dyskinesia / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires