Related Experiment Video
Updated: Aug 24, 2026
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Predictors of successful outcome after cholecystectomy for biliary dyskinesia
David E Carney1, Evan R Kokoska, Jay L Grosfeld
1Section of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine and the J.W. Riley Hospital for Children, Indianapolis, IN 46202, USA.
Insights
Children with nausea, pain, and gallbladder ejection fraction under 15% are most likely to benefit from cholecystectomy for biliary dyskinesia. This surgery improves outcomes for pediatric patients with gallbladder dysfunction.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Laparoscopic cholecystectomy is a common treatment for pediatric biliary dyskinesia.
- However, many children experience poor clinical response post-surgery.
- Predictors of successful outcomes require identification.
Purpose of the Study:
- To identify clinical and radiographic predictors of successful outcomes following laparoscopic cholecystectomy for biliary dyskinesia in children.
- To improve patient selection for this surgical intervention.
Main Methods:
- Retrospective review of 51 children who underwent laparoscopic cholecystectomy for biliary dyskinesia (1990-2003).
- Evaluation of clinical symptoms, radiographic findings (gallbladder ejection fraction), and pathology.
- Logistic regression analysis to determine independent predictors of successful outcome based on patient satisfaction scores.
Main Results:
- 71% of followed patients (27/38) reported complete symptom resolution.
- Nausea was a significant predictor of success (OR 5.00).
- Gallbladder ejection fraction <15% strongly predicted success (OR 8.00). Combined with pain and nausea, it yielded a positive predictive value of 93%.
Conclusions:
- Nausea, abdominal pain, and a gallbladder ejection fraction <15% are reliable predictors of successful cholecystectomy for pediatric biliary dyskinesia.
- These factors can help guide surgical decisions and improve patient selection.
- Identifying these predictors enhances the effectiveness of surgical treatment for this condition.
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.
Related Concept Videos
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:20Cholecystitis