title: Gallbladder dysfunction: how much longer will it be controversial?
abstract: BACKGROUND
  Motility disorders of the biliary tree [biliary dyskinesia, including both gallbladder dysfunction (GBD), and sphincter of Oddi dysfunction] are difficult to diagnose and to treat.
  
  
  CONCLUSIONS
  There is controversy in the literature in particular regarding the criteria that should be used to select patients for cholecystectomy (CCY) in cases of suspected GBD. The current review covers the history, diagnosis, and treatment of GBD. Key Messages: Only >85% of patients with suspected GBD have relief following CCY, a much lower rate than the nearly 100% success rate following CCY for gallstone disease. Unfortunately, the literature is lacking, and there are no universally agreed-upon criteria for selecting which patients to refer for operation, although cholecystokinin (CCK)-enhanced hepatobiliary iminodiacetic acid scan is often used, with emphasis on an abnormally low gallbladder ejection fraction or pain reproduction at CCK administration. There is a clear need for large, well-designed, more definitive, prospective studies to better identify the indications for and efficacy of CCY in cases of GBD.
authors.affiliation: Department of Surgery, Saint Agnes Hospital, Baltimore, Md., USA.
authors.forename: Naeem
authors.initials: N
authors.lastname: Goussous
authors.forename: Gopal C
authors.initials: GC
authors.lastname: Kowdley
authors.forename: Neeraj
authors.initials: N
authors.lastname: Sardana
authors.forename: Ethan
authors.initials: E
authors.lastname: Spiegler
authors.forename: Steven C
authors.initials: SC
authors.lastname: Cunningham
mesh_terms: D001657:Biliary Dyskinesia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D002756:Cholagogues and Choleretics; D002763:Cholecystectomy / Q000639:trends; D002766:Cholecystokinin; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D046628:Sphincter of Oddi Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery
chemical_list: D002756:Cholagogues and Choleretics; D002766:Cholecystokinin