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Biliary dyskinesia in children.

Hossam S Al-Homaidhi1, Husam Sukerek, Michael Klein

  • 1Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien St., Detroit, MI 48201, USA.

Pediatric Surgery International
|November 5, 2002
PubMed
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Biliary dyskinesia (BD) in children causes chronic abdominal pain. Cholecystectomy effectively relieved symptoms in pediatric patients with delayed gallbladder ejection fraction, indicating its therapeutic value.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatobiliary Surgery
  • Diagnostic Imaging

Background:

  • Biliary dyskinesia (BD) is a recognized cause of chronic abdominal pain in adults, though less common in pediatric populations.
  • Diagnosis in children can be challenging, often requiring exclusion of other causes of abdominal pain.
  • Gallbladder dysfunction, specifically impaired emptying, is a key feature of BD.

Purpose of the Study:

  • To review the diagnosis, treatment, and outcomes of pediatric patients with biliary dyskinesia.
  • To evaluate the efficacy of cholecystectomy in managing chronic abdominal pain associated with BD in children.
  • To assess the role of cholecystokinin-stimulated gallbladder ejection fraction in diagnosing BD.

Main Methods:

  • Retrospective review of pediatric patients undergoing cholecystectomy for BD between March 1995 and October 2000.

Related Experiment Videos

  • Inclusion criteria: chronic upper abdominal pain, normal ultrasonography, and delayed gallbladder ejection fraction (<35%) on CCK-HIDA scintigraphy.
  • Data collected included symptom duration, diagnostic tests, surgical intervention (laparoscopic cholecystectomy), and patient outcomes.

    • Main Results:

    • Ten pediatric patients (13.5%) underwent cholecystectomy for BD during the study period.
    • Mean symptom duration was 22 months, with a range of 1-60 months.
    • All patients experienced complete symptom relief following laparoscopic cholecystectomy, with a mean follow-up of 12.8 months.

    Conclusions:

    • Cholecystectomy should be considered for children presenting with chronic upper-abdominal pain and confirmed delayed gallbladder ejection fraction.
    • Laparoscopic cholecystectomy is an effective and recommended surgical treatment for pediatric biliary dyskinesia.
    • CCK-HIDA scintigraphy is crucial for diagnosing BD in children with unexplained abdominal pain.