A Community Hospital Experience With Cholecystectomy for Gallbladder Hyperkinesia: A Single-Center Cross-Sectional...

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary Tract Disorders

Background:

• Hyperkinetic and hypokinetic biliary dyskinesia often present with right upper quadrant pain, mimicking other biliary conditions.
• Gallbladder hypokinesia is an accepted indication for cholecystectomy, but evidence for hyperkinesia is less established.
• Gallbladder hyperkinesia may also be an indication for cholecystectomy, warranting further investigation.

Purpose of the Study:

• To evaluate the efficacy of cholecystectomy in patients with gallbladder hyperkinesia.
• To determine the association between gallbladder ejection fraction and symptomatic outcomes post-cholecystectomy.
• To analyze the relationship between presenting symptoms and symptom resolution after surgery.

Main Methods:

• Single-center cross-sectional study of patients aged 18+ with gallbladder ejection fraction >80% on HIDA scan.
• Included patients who underwent cholecystectomy between January 2018 and February 2023 with at least one postoperative visit.
• Primary outcome was symptomatic resolution or improvement, analyzed alongside gallbladder ejection fraction and presenting symptoms.

Main Results:

• 67 patients (median age 46, 75% female) were analyzed with a median 30-day follow-up.
• 94% experienced partial symptom improvement, and 85% had complete resolution of symptoms like abdominal pain, nausea, vomiting, and diarrhea.
• A higher gallbladder ejection fraction (94% vs. 88%) was significantly associated with complete symptom resolution (P=0.033). Chronic cholecystitis was found in 73% of specimens.

Conclusions:

• Laparoscopic cholecystectomy is supported as a treatment for gallbladder hyperkinesia.
• Elevated gallbladder ejection fraction is linked to complete symptomatic improvement following cholecystectomy.
• Presenting symptoms did not appear to influence the likelihood of complete symptom resolution.