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

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.

• Authors: E Marty Knott, Frankie B Fike, Alessandra C Gasior, Robert Cusick, Evan Brownie, Shawn D St Peter, Kenneth S Azarow
• Journal: Pediatric surgery international (Pediatr Surg Int) Vol. 29 Issue 12 Pg. 1243-7 (Dec 2013) ISSN: 1437-9813 [Electronic] Germany
• PMID: 23846453 (Publication Type: Journal Article, Multicenter Study)

Topics

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