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Laparoscopic cholecystectomy for biliary dyskinesia in children provides durable symptom relief
Ramanath N Haricharan1, Lyudmila V Proklova, Charles J Aprahamian
1Department of Surgery, Division of Pediatric Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Insights
Laparoscopic cholecystectomy effectively relieves symptoms in children diagnosed with biliary dyskinesia. This surgical procedure offers significant short-term and long-term symptom improvement for pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Hepatobiliary System
Background:
- Biliary dyskinesia is a condition causing chronic abdominal pain in children.
- Abnormal gallbladder ejection fraction, often diagnosed via cholecystokinin (CCK)-stimulated HIDA scans, is a key indicator.
- Laparoscopic cholecystectomy is a minimally invasive surgical option.
Purpose of the Study:
- To evaluate the effectiveness of laparoscopic cholecystectomy for treating biliary dyskinesia in pediatric patients.
- To assess both short-term and long-term symptom relief following the procedure.
Main Methods:
- Retrospective review of pediatric patients with abnormal CCK-HIDA scans undergoing laparoscopic cholecystectomy (2001-2006).
- Postoperative assessment using a 23-item Likert scale symptom questionnaire administered to parents.
- Analysis of preoperative symptoms and postoperative outcomes.
Main Results:
- Twenty-three children with biliary dyskinesia underwent laparoscopic cholecystectomy, presenting with symptoms like right upper quadrant pain, nausea, and vomiting.
- Postoperative follow-up revealed significant symptom improvement: 63% reported no abdominal pain, 87% no vomiting, and 69% no nausea.
- Overall, 67% of parents indicated complete symptom relief after surgery.
Conclusions:
- Laparoscopic cholecystectomy is an effective treatment for pediatric biliary dyskinesia.
- The procedure provides substantial short-term and long-term relief from symptoms associated with the condition.
- Surgical intervention can significantly improve the quality of life for children suffering from biliary dyskinesia.
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.
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