Laparoscopic cholecystectomy for biliary dyskinesia in children provides durable symptom relief.

Abstract

PURPOSE:

The purpose of this study was to determine the effectiveness of laparoscopic cholecystectomy in children with biliary dyskinesia.

METHODS:

Reports of children with an abnormal cholecystokinin (CCK)-stimulated HIDA scan between January 2001 and July 2006 who underwent laparoscopic cholecystectomy were reviewed. Postoperatively, a 23-item Likert scale, symptom questionnaire was administered to parents.

RESULTS:

Sixty-four children with chronic abdominal pain and no gallstones on ultrasound had an abnormal CCK-HIDA scan. Twenty-three children (median age, 14 years; 16 girls), with mean (SD) ejection fraction of 17% (8), underwent laparoscopic cholecystectomy and were further analyzed. Preoperatively, these children had right upper quadrant/epigastric pain (78%), nausea (52%), vomiting (43%), and generalized abdominal pain (22%) lasting for a median of 3 months (range, 1 month to 2.5 years). Median postoperative follow-up was 2.7 years. Sixteen (70%) parents completed the questionnaire. Of those who responded, 63% indicated that their children had no abdominal pain, 87% had no vomiting, and 69% had no nausea in the month preceding the questionnaire. Overall, 67% of parents indicated that their children's symptoms were completely relieved after cholecystectomy, whereas 7% indicated that the symptoms were not relieved.

CONCLUSION:

Laparoscopic cholecystectomy is effective in providing both short-term and long-term improvement of symptoms in children with biliary dyskinesia.

• Authors: Ramanath N Haricharan, Lyudmila V Proklova, Charles J Aprahamian, Traci L Morgan, Carroll M Harmon, Douglas C Barnhart, Shehzad A Saeed
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 43 Issue 6 Pg. 1060-4 (Jun 2008) ISSN: 1531-5037 [Electronic] United States
• PMID: 18558183 (Publication Type: Journal Article)

Topics

• Abdominal Pain (diagnosis, etiology)
• Adolescent
• Biliary Dyskinesia (diagnosis, surgery)
• Child
• Cholecystectomy, Laparoscopic (adverse effects, methods)
• Chronic Disease
• Female
• Humans
• Male
• Pain Measurement
• Patient Satisfaction
• Postoperative Complications (epidemiology)
• Preoperative Care (methods)
• Prognosis
• Quality of Life
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Surveys and Questionnaires