title: Biliary dyskinesia: how effective is cholecystectomy?
abstract: BACKGROUND
  Studies on biliary dyskinesia have been based on short-term surgical follow-up and do not take into consideration that most patients are discharged from surgical follow-up after the first postoperative visit and that for persistent or recurrent symptoms they are frequently seen by primary care providers and subsequently referred to gastroenterologists. We aimed to study this pattern and assess which factors predict patients that will benefit from cholecystectomy.
  
  
  METHODS
  This is a retrospective analysis of medical records of patients who underwent cholecystectomy for biliary dyskinesia from February 2001 to January 2010 with a minimum postoperative follow-up of 6 months.
  
  
  RESULTS
  At initial surgical follow-up, 19 of 141 (13.4%) patients said they had persistent symptoms. However, when subsequent visits were analyzed, 61 of 141 (43.3%) patients with persistent or recurrent symptoms saw their primary care provider. These symptoms were epigastric or right upper quadrant pain in 43 patients or 30% of those undergoing cholecystectomy. The only factor that distinguished patients with and without resolution of symptoms after cholecystectomy was the pathologic finding of inflammation (p = 0.02).
  
  
  CONCLUSIONS
  Cholecystectomy does not appear to be as effective for biliary dyskinesia when long-term follow-up is evaluated.
authors: Department of Surgery, Guthrie-Robert Packer Hospital, 1 Guthrie Sq, Sayre, 18840, PA, USA. singhalvik@gmail.com
authors: Vikas
authors: V
authors: Singhal
authors: Patrick
authors: P
authors: Szeto
authors: Heather
authors: H
authors: Norman
authors: Nan
authors: N
authors: Walsh
authors: Burt
authors: B
authors: Cagir
authors: Thomas J
authors: TJ
authors: VanderMeer
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001657:Biliary Dyskinesia / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002763:Cholecystectomy; D002764:Cholecystitis / Q000150:complications; D002766:Cholecystokinin; D005260:Female; D005500:Follow-Up Studies; D005762:Gastroenterology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011320:Primary Health Care / Q000706:statistics & numerical data; D012008:Recurrence; D012017:Referral and Consultation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002766:Cholecystokinin