Multi-institutional analysis of long-term symptom resolution after cholecystectomy for biliary dyskinesia in children

Pediatr Surg Int. 2013 Dec;29(12):1243-7. doi: 10.1007/s00383-013-3343-3. Epub 2013 Jul 12.

Abstract

Purpose: 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.

Conclusion: 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.

Publication types

  • Multicenter Study

MeSH terms

  • Abdominal Pain / complications*
  • Adolescent
  • Adult
  • Biliary Dyskinesia / complications*
  • Biliary Dyskinesia / surgery*
  • Body Mass Index
  • Child
  • Cholecystectomy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Patient Satisfaction / statistics & numerical data
  • Postoperative Period
  • Treatment Outcome
  • Young Adult