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Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis
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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.

Journal of Pediatric Surgery
|May 28, 2011
PubMed
Summary
This summary is machine-generated.

Laparoscopic cholecystectomy for pediatric biliary dyskinesia has inconsistent outcomes. Non-overweight children with biliary dyskinesia are more likely to achieve symptom resolution after surgery.

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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.