Background: Although biliary dyskinesia is treated commonly with cholecystectomy, the supporting
literature is limited. A review and meta-analysis of the literature were performed to assess the
efficacy of surgical therapy for biliary dyskinesia.
Materials and Methods: A MEDLINE search for the period 1965 to 2003, using the search strings
"biliary," "acalculous," "dyskinesia," "cholecystitis," "cholecystectomy," and "therapy" returned
187 articles. Inclusion criteria required a study design that placed patients with biliary dyskinesia
into one of two treatment groups, cholecystectomy or nonoperative therapy, and a follow-up assessment
of symptomatic improvement.
Results: Five studies met the inclusion criteria, representing a total of 274 patients. Surgical therapy
resulted in 98% symptomatic relief compared to 32% with nonoperative management (P <
0.0001). Patients undergoing surgical therapy for biliary dyskinesia were 2.79 times more likely to
have symptomatic relief versus nonoperative therapy (95% confidence interval, 2.05–3.79).
Conclusion: Based on this meta-analysis, cholecystectomy for biliary dyskinesia is an effective
therapy and offers significant symptomatic relief over nonoperative therapy.
