Abstract | PURPOSE: METHODS: With ethics approval, a retrospective chart review was performed on children (<21 years) at a single center diagnosed with biliary dyskinesia (defined as gallbladder ejection fraction [EF] <35% and/or pain with cholecystokinin [CCK] on cholescintigraphy, in the absence of gallstones or cholecystitis on ultrasound) and treated with laparoscopic cholecystectomy between March 2010 and February 2016. Demographic, medical history, diagnostic imaging, pathology, and outcome data were collected and analyzed based on degree of symptom resolution. RESULTS:
Laparoscopic cholecystectomy was performed in 215 children with biliary dyskinesia (156/215 [72.6%] female, age 13.8 ± 3.4 years, body mass index [BMI] 22.3 ± 6.3 kg/m2). 181/206 (87.9%) had EF <35%. CCK reproduced symptoms in 149/177 (84.2%). 34/215 (15.8%) were lost to follow-up. Median follow-up time was 2.7 weeks. Pain improved in 162/181 (89.5%). Chronic cholecystitis was found in 183/213 (85.9%) and unexpected cholelithiasis in 4/213 (1.9%) on pathology. Postoperatively, 6/181 (3.3%) had wound infections and 8/181 (4.4%) required common bile duct stents for the following indications: 6 sphincter of Oddi dysfunction, 1 choledocholithiasis, and 1 stricture. Virgin abdomen (odds ratio [OR] 4.03, confidence interval [95% CI] 1.12-14.53, P = .0460) and follow-up <6 months (OR 7.35, 95% CI 2.68-20.21, P = .0002) were associated with better outcomes. CONCLUSIONS:
|
Authors | Sarah W Lai, Steven S Rothenberg, Saundra M Kay, Kristin E Shipman, Bethany J Slater |
Journal | Journal of laparoendoscopic & advanced surgical techniques. Part A
(J Laparoendosc Adv Surg Tech A)
Vol. 27
Issue 8
Pg. 845-850
(Aug 2017)
ISSN: 1557-9034 [Electronic] United States |
PMID | 28350202
(Publication Type: Journal Article)
|
Topics |
- Adolescent
- Analysis of Variance
- Biliary Dyskinesia
(surgery)
- Child
- Cholecystectomy, Laparoscopic
(methods)
- Choledocholithiasis
(surgery)
- Female
- Humans
- Male
- Regression Analysis
- Retrospective Studies
- Risk Factors
|