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Biliary hyperkinesia in adolescents-it isn't all hype!
Maggie E Bosley1, Jillian Jacobson2, Michaela W G Gaffley1
1Department of General Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Translational Gastroenterology and Hepatology
|August 23, 2021
Summary
Biliary hyperkinesia, a condition of gallbladder hyperfunction, is increasingly seen in adolescents. Laparoscopic cholecystectomy offers a potential surgical cure for these patients experiencing biliary colic symptoms.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Biliary dyskinesia is typically defined as gallbladder hypofunction (EF <35%) on CCK-HIDA scans.
- Biliary hyperkinesia, characterized by high gallbladder ejection fraction (EF), is less understood in pediatric populations.
- This study investigates the presentation and treatment of biliary hyperkinesia in adolescents.
Purpose of the Study:
- To describe the clinical characteristics of adolescents diagnosed with biliary hyperkinesia.
- To evaluate the efficacy of surgical intervention for this condition in pediatric patients.
- To establish biliary hyperkinesia as a distinct clinical entity in adolescents.
Main Methods:
- Retrospective review of patients with elevated CCK-HIDA EF (>80%) over three years.
- Data collected included age, sex, BMI, CCK-HIDA results, and surgical pathology.
- Symptom resolution was assessed via subjective patient self-reporting post-surgery.
Main Results:
- Eighteen adolescents (average age 15.7 years, 15 female) were included.
- Average CCK-HIDA EF was 91.6%, with 82.4% showing chronic cholecystitis or cholesterolosis on pathology.
- 82.4% of followed patients reported complete or near-complete symptom resolution after surgery.
Conclusions:
- Biliary hyperkinesia is an emerging condition in adolescents presenting similarly to biliary hypokinesia.
- Laparoscopic cholecystectomy appears to be an effective surgical treatment for pediatric biliary hyperkinesia.
- Consider biliary hyperkinesia in the differential diagnosis for adolescents with biliary colic and normal workups.
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