title: Multi-institutional analysis of long-term symptom resolution after cholecystectomy for biliary dyskinesia in children.
abstract: OBJECTIVE
  Current literature for resolution of abdominal pain after cholecystectomy in children with biliary dyskinesia shows variable outcomes. We sought to compare early outcomes with long-term symptom resolution in children.
  
  
  METHODS
  Telephone surveys were conducted on children who underwent cholecystectomy for biliary dyskinesia between January 2000 and January 2011 at two centers. Retrospective review was performed to obtain demographics and short-term outcomes.
  
  
  RESULTS
  Charts of 105 patients' age 7.9-19 years were reviewed; 80.9 % were female. All were symptomatic with an ejection fraction (EF) <35 % or pain with cholecystokinin administration. At the postoperative visit, 76.1 % had resolution of symptoms. Fifty-six (53.3 %) patients were available for follow-up at median 3.7 (1.1-10.7) years. Of these, 34 (60.7 %) reported no ongoing abdominal pain. Of the 22 patients with persistent symptoms, satisfaction score was 7.3 ± 2.7 (scale of 1-10) and 19 (86.4 %) were glad that they had a cholecystectomy performed. EF, body mass index percentile (BMI %), and pain with cholecystokinin (CCK) were not predictive of ongoing pain at either follow-up periods.
  
  
  CONCLUSIONS
  Short-term symptom resolution in children undergoing cholecystectomy for biliary dyskinesia is not reflective of long-term results. Neither EF, BMI % nor pain with CCK was predictive of symptom resolution. The majority of patients with ongoing complaints do not regret cholecystectomy.
authors.affiliation: Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: E Marty
authors.initials: EM
authors.lastname: Knott
authors.forename: Frankie B
authors.initials: FB
authors.lastname: Fike
authors.forename: Alessandra C
authors.initials: AC
authors.lastname: Gasior
authors.forename: Robert
authors.initials: R
authors.lastname: Cusick
authors.forename: Evan
authors.initials: E
authors.lastname: Brownie
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Azarow
mesh_terms: D015746:Abdominal Pain / Q000150:complications*; D000293:Adolescent; D000328:Adult; D001657:Biliary Dyskinesia / Q000150:complications* / Q000601:surgery*; D015992:Body Mass Index; D002648:Child; D002763:Cholecystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011184:Postoperative Period; D016896:Treatment Outcome; D055815:Young Adult