Negative workup? Laparoscopic cholecystectomy Still alleviates symptoms

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary System Diagnostics

Background:

• Abdominal pain is often linked to biliary dyskinesia, with laparoscopic cholecystectomy showing symptom improvement in patients with low ejection fraction (<35%).
• Evidence is limited regarding the efficacy of laparoscopic cholecystectomy for patients presenting with biliary symptoms and a normal ejection fraction (>35%).

Purpose of the Study:

• To evaluate the effectiveness of laparoscopic cholecystectomy in patients experiencing biliary pain despite a normal gallbladder ejection fraction.
• To determine if surgical intervention offers symptom resolution in cases of normokinetic biliary disease.

Main Methods:

• A retrospective, single-center study included 117 patients with biliary pain and normal HIDA scan ejection fraction (>35%) treated between 2017 and 2022.
• Patients underwent laparoscopic cholecystectomy after negative workups, with follow-up assessments of symptom resolution.

Main Results:

• 84% of patients reported resolution of preoperative symptoms following laparoscopic cholecystectomy.
• No statistically significant correlation was found between pain during CCK-HIDA administration or ejection fraction and symptom resolution.

Conclusions:

• Laparoscopic cholecystectomy is a beneficial treatment for abdominal pain associated with normokinetic biliary disease.
• Early surgical intervention may prevent prolonged diagnostic processes and misdiagnosis in patients with biliary pain and normal ejection fraction.