Hyperkinetic gallbladder: an indication for cholecystectomy?
Cholecystectomy may benefit children with biliary colic without stones on ultrasound (US) or low ejection fraction on cholecystokinin-hepatobiliary iminodiacetic acid (CCK-HIDA) scan. Children with symptomatic biliary colic and abnormal HIDA scan, specifically those with high ejection fractions, may benefit from cholecystectomy. All patients younger than 18 years old undergoing cholecystectomy from 2008 to 2012 in our practice were reviewed. Patients with a negative US and CCK-HIDA ejection fractions 80 per cent or greater were included in the study. Patient data were extracted from charts, whereas postoperative symptoms were obtained by phone interviews. Of 174 patients who underwent cholecystectomy, 12 (7%) met study criteria. All patients (12 of 12) had evidence of cholecystitis on the final pathology note. All 11 patients contacted had relief of colic after gallbladder removal with a mean follow-up of 16 months. A subset of pediatric patients with high ejection fractions on CCK-HIDA and symptomatic biliary colic may have symptomatic relief with cholecystectomy.
Department of Surgery, Louisiana State University, New Orleans, Louisiana, USA.
Erika B
EB
Lindholm
J Brannon
JB
Alberty
Faith
F
Hansbourgh
James R
JR
Upp
John
J
Lopoo
D000293:Adolescent; D001657:Biliary Dyskinesia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002763:Cholecystectomy; D005260:Female; D005704:Gallbladder / Q000503:physiopathology*; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016473:Gallbladder Emptying; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors