Related Experiment Video
Updated: Jun 1, 2026
Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis
Published on: February 10, 2015
Pathologic changes in biliary dyskinesia
Evan Brownie1, Robert A Cusick, Deborah A Perry
1Department of Surgery, Children's Hospital and Medical Center, University of Nebraska College of Medicine, Omaha, NE, USA.
Insights
Laparoscopic cholecystectomy for pediatric biliary dyskinesia has inconsistent outcomes. Non-overweight children with biliary dyskinesia are more likely to achieve symptom resolution after surgery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Biliary Disease
Background:
- Laparoscopic cholecystectomy is a common treatment for pediatric upper abdominal pain attributed to acalculous biliary disease.
- Outcomes following this procedure in children are variable, necessitating identification of predictive factors.
Purpose of the Study:
- To identify predictors of symptomatic resolution after laparoscopic cholecystectomy in children evaluated for acalculous biliary disease.
Main Methods:
- A retrospective review of 167 children who underwent laparoscopic cholecystectomy.
- Evaluation of radiographic findings, histopathology, family history, and demographics (including body mass index-for-age percentile) as predictors of postoperative symptom resolution.
- Blinded re-review of radiologic and pathologic specimens.
Main Results:
- Symptom resolution was achieved in 68.3% of patients.
- Preoperative factors such as ejection fraction, pain on cholecystokinin injection, and family history of biliary disease did not predict resolution.
- Non-overweight children (body mass index-for-age <85th percentile) had significantly higher rates of symptom resolution (OR, 2.13).
- Pathologic findings on gallbladder examination did not correlate with outcomes.
Conclusions:
- The majority of gallbladders removed for biliary dyskinesia exhibit pathology.
- Overweight status in children may be a relative contraindication for cholecystectomy in the context of biliary dyskinesia, given the lower likelihood of symptom resolution.
Purpose:
For children with upper abdominal pain and evaluation for acalculous biliary disease, laparoscopic cholecystectomy is an accepted treatment with inconsistent outcomes. The purpose of this study was to identify predictors of outcomes.
Methods:
One hundred sixty-seven children underwent laparoscopic cholecystectomy at a single children's hospital. Radiographic findings, histopathology, family history, and demographics (sex, age, height, weight, body mass index-for-age percentile) were evaluated as predictors of postoperative symptomatic resolution using a binomial probability model. The data for radiologic studies and pathologic specimens were obtained via re-review in a blinded fashion.
Results:
Of 167 children, 43 (25.7%) had a preoperative diagnosis of biliary dyskinesia and 41 (95.3%) had documented follow-up. Mean follow-up was 8.4 months. Twenty-eight patients (68.3%) had symptom resolution. Ejection fraction less than or equal to 15%, pain upon cholecystokinin injection, and a family history of biliary disease were not predictors of symptomatic resolution. Nonoverweight patients (body mass index-for-age <85th percentile) were more likely to have symptom resolution than their overweight counterparts (odds ratio, 2.13). Most patients (68.3%) had a pathologic gallbladder on blinded review. However, this did not correlate with outcome.
Conclusions:
Most gallbladders removed for biliary dyskinesia are pathologic. Being overweight can be considered a relative contraindication to cholecystectomy for biliary dyskinesia.
Related Concept Videos
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:11Alterations in Muscle Tone lll
01:21Chronic Pancreatitis II: Pathophysiology
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:25Chronic Pancreatitis I: Introduction
01:24Parkinson Disease ll: Pathophysiology