Association of gallbladder hyperkinesia with acalculous chronic cholecystitis: A case-control study

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary System Disorders

Background:

• Gallbladder hyperkinesia is increasingly recognized as a cause of biliary pain.
• Acalculous chronic cholecystitis associated with gallbladder hyperkinesia lacks definitive treatment guidelines.
• This study is the first case-control investigation into the efficacy of cholecystectomy for this condition.

Purpose of the Study:

• To determine the association between gallbladder hyperkinesia and symptomatic acalculous chronic cholecystitis.
• To compare the resolution of biliary pain in patients undergoing cholecystectomy versus medical management.
• To evaluate cholecystectomy as a potential treatment for gallbladder hyperkinesia.

Main Methods:

• Retrospective case-control study at a single academic center.
• Inclusion criteria: adults with gallbladder hyperkinesia (HIDA scan ejection fraction ≥80%) and biliary pain.
• Groups: cholecystectomy (study) vs. medical management (control). Pain resolution and demographics were compared.

Main Results:

• Cholecystectomy resulted in pain resolution in 86% of patients (18/21).
• Medical management provided pain relief in only 20% of patients (5/25) after a mean follow-up of 36 months.
• The odds of pain resolution were 19.7 times greater with cholecystectomy (OR, 19.7; 95% CI, 4.34-89.43; P < .01).

Conclusions:

• Symptomatic gallbladder hyperkinesia is a strong indicator for cholecystectomy.
• Cholecystectomy offers a highly effective solution for biliary pain in these patients.
• This study suggests gallbladder hyperkinesia may represent a new indication for surgical intervention.