Abstract
Background
Hyperkinetic and hypokinetic biliary dyskinesia commonly present with right upper quadrant pain, mimicking biliary colic or cholecystitis. Only gallbladder hypokinesia is a well-accepted indication for cholecystectomy. While there is less literature on the topic, patients with gallbladder hyperkinesia may also benefit from cholecystectomy.
Methods
This single-center cross-sectional study looked at patients 18 years or older, with EF >80% on HIDA scan who underwent cholecystectomy and at least one postoperative visit from January 1, 2018, to February 28, 2023. The primary outcome was symptomatic resolution or improvement.
Results
In total, 67 patients were identified, with a median age of 46 years, 75% female sex, and a median 30-day follow-up period. All patients presented with abdominal pain, 64% presented with nausea and vomiting, and 31% presented with chronic diarrhea. Partial symptomatic improvement was noted in 94% of patients, while 85% had complete resolution. There was a statistically significant difference in gallbladder ejection fraction between 2 groups: 94% (IQR 90-98%) for those with complete symptom resolution vs 88% (IQR 83-97%) for those who did not have symptom resolution (P = 0.033). Chronic cholecystitis was demonstrated in 73% of specimens.
Conclusions
This data adds to a body of evidence supporting laparoscopic cholecystectomy for gallbladder hyperkinesia. The study further establishes a higher degree of gallbladder ejection fraction to have an association with complete symptomatic improvement after cholecystectomy. A patient’s presenting symptoms do not appear to have an association with complete symptom resolution.
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