Predictors of successful outcome after cholecystectomy for biliary dyskinesia

David E. Carney, Evan R. Kokoska, Jay L. Grosfeld, Scott A. Engum, Thomas M. Rouse, Karen M. West, Alan Ladd, Frederick Rescorla

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Purpose Laparoscopic cholecystectomy is accepted therapy for children with ill-defined abdominal pain and impaired gallbladder emptying (biliary dyskinesia). Follow-up shows poor clinical response in many of these patients. The purpose of this report is to identify clinical and radiographic predictors of successful outcome after cholecystectomy for biliary dyskinesia. Methods The authors retrospectively reviewed records of 51 children after laparoscopic cholecystectomy for biliary dyskinesia (1990 to 2003). Clinical symptoms, radiographic findings, and pathology were evaluated. Subjective clinical improvement is stratified using an established patient satisfaction score. Logistic regression analysis determines statistically independent predictors of successful outcome. Results Thirty-eight of 51 (75%) patients were available for follow-up. Twenty-seven of 38 (71%) patients reported complete resolution of symptoms. Nausea was the only symptom predictive of successful outcome by univariate analysis (odds ratio, 5.00). A cholecystokinin-stimulated, gallbladder ejection fraction less than 15% also predicts successful outcome (odds ratio, 8.00). Children with an ejection fraction greater than 15% did not have predictable resolution of symptoms. When present with pain and nausea, gallbladder emptying less than 15% has a positive predictive value of 93% and a negative predictive value of 81%. Conclusions Together, nausea, pain, and decreased gallbladder emptying (<15%) most reliably predict which children will benefit from cholecystectomy for biliary dyskinesia.

Original languageEnglish
Pages (from-to)813-816
Number of pages4
JournalJournal of Pediatric Surgery
Volume39
Issue number6
DOIs
StatePublished - Jun 2004

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Biliary Dyskinesia
Gallbladder Emptying
Cholecystectomy
Nausea
Laparoscopic Cholecystectomy
Odds Ratio
Pain
Cholecystokinin
Gallbladder
Patient Satisfaction
Abdominal Pain
Logistic Models
Regression Analysis
Pathology

Keywords

  • Biliary dyskinesia
  • cholecystokinin-stimulated ejection fraction
  • laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Carney, D. E., Kokoska, E. R., Grosfeld, J. L., Engum, S. A., Rouse, T. M., West, K. M., ... Rescorla, F. (2004). Predictors of successful outcome after cholecystectomy for biliary dyskinesia. Journal of Pediatric Surgery, 39(6), 813-816. https://doi.org/10.1016/j.jpedsurg.2004.02.017

Predictors of successful outcome after cholecystectomy for biliary dyskinesia. / Carney, David E.; Kokoska, Evan R.; Grosfeld, Jay L.; Engum, Scott A.; Rouse, Thomas M.; West, Karen M.; Ladd, Alan; Rescorla, Frederick.

In: Journal of Pediatric Surgery, Vol. 39, No. 6, 06.2004, p. 813-816.

Research output: Contribution to journalArticle

Carney, DE, Kokoska, ER, Grosfeld, JL, Engum, SA, Rouse, TM, West, KM, Ladd, A & Rescorla, F 2004, 'Predictors of successful outcome after cholecystectomy for biliary dyskinesia', Journal of Pediatric Surgery, vol. 39, no. 6, pp. 813-816. https://doi.org/10.1016/j.jpedsurg.2004.02.017
Carney, David E. ; Kokoska, Evan R. ; Grosfeld, Jay L. ; Engum, Scott A. ; Rouse, Thomas M. ; West, Karen M. ; Ladd, Alan ; Rescorla, Frederick. / Predictors of successful outcome after cholecystectomy for biliary dyskinesia. In: Journal of Pediatric Surgery. 2004 ; Vol. 39, No. 6. pp. 813-816.
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