Pathologic changes in biliary dyskinesia

Evan Brownie, Robert A. Cusick, Deborah A. Perry, Sandra Allbery, Kenneth S. Azarow

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: For children with upper abdominal pain and evaluation for acalculous biliary disease, laparoscopic cholecystectomy is an accepted treatment with inconsistent outcomes. The purpose of this study was to identify predictors of outcomes. Methods: One hundred sixty-seven children underwent laparoscopic cholecystectomy at a single children's hospital. Radiographic findings, histopathology, family history, and demographics (sex, age, height, weight, body mass index-for-age percentile) were evaluated as predictors of postoperative symptomatic resolution using a binomial probability model. The data for radiologic studies and pathologic specimens were obtained via re-review in a blinded fashion. Results: Of 167 children, 43 (25.7%) had a preoperative diagnosis of biliary dyskinesia and 41 (95.3%) had documented follow-up. Mean follow-up was 8.4 months. Twenty-eight patients (68.3%) had symptom resolution. Ejection fraction less than or equal to 15%, pain upon cholecystokinin injection, and a family history of biliary disease were not predictors of symptomatic resolution. Nonoverweight patients (body mass index-for-age <85th percentile) were more likely to have symptom resolution than their overweight counterparts (odds ratio, 2.13). Most patients (68.3%) had a pathologic gallbladder on blinded review. However, this did not correlate with outcome. Conclusions: Most gallbladders removed for biliary dyskinesia are pathologic. Being overweight can be considered a relative contraindication to cholecystectomy for biliary dyskinesia.

Original languageEnglish (US)
Pages (from-to)879-882
Number of pages4
JournalJournal of pediatric surgery
Volume46
Issue number5
DOIs
StatePublished - May 1 2011

Fingerprint

Biliary Dyskinesia
Laparoscopic Cholecystectomy
Gallbladder
Body Mass Index
Cholecystokinin
Cholecystectomy
Statistical Models
Abdominal Pain
Odds Ratio
Demography
Weights and Measures
Pain
Injections

Keywords

  • Acalculous biliary disease
  • Biliary dyskinesia
  • Laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Pathologic changes in biliary dyskinesia. / Brownie, Evan; Cusick, Robert A.; Perry, Deborah A.; Allbery, Sandra; Azarow, Kenneth S.

In: Journal of pediatric surgery, Vol. 46, No. 5, 01.05.2011, p. 879-882.

Research output: Contribution to journalArticle

Brownie, E, Cusick, RA, Perry, DA, Allbery, S & Azarow, KS 2011, 'Pathologic changes in biliary dyskinesia', Journal of pediatric surgery, vol. 46, no. 5, pp. 879-882. https://doi.org/10.1016/j.jpedsurg.2011.02.021
Brownie, Evan ; Cusick, Robert A. ; Perry, Deborah A. ; Allbery, Sandra ; Azarow, Kenneth S. / Pathologic changes in biliary dyskinesia. In: Journal of pediatric surgery. 2011 ; Vol. 46, No. 5. pp. 879-882.
@article{38442fa11ddd46ffa39732a95ae34bad,
title = "Pathologic changes in biliary dyskinesia",
abstract = "Purpose: For children with upper abdominal pain and evaluation for acalculous biliary disease, laparoscopic cholecystectomy is an accepted treatment with inconsistent outcomes. The purpose of this study was to identify predictors of outcomes. Methods: One hundred sixty-seven children underwent laparoscopic cholecystectomy at a single children's hospital. Radiographic findings, histopathology, family history, and demographics (sex, age, height, weight, body mass index-for-age percentile) were evaluated as predictors of postoperative symptomatic resolution using a binomial probability model. The data for radiologic studies and pathologic specimens were obtained via re-review in a blinded fashion. Results: Of 167 children, 43 (25.7{\%}) had a preoperative diagnosis of biliary dyskinesia and 41 (95.3{\%}) had documented follow-up. Mean follow-up was 8.4 months. Twenty-eight patients (68.3{\%}) had symptom resolution. Ejection fraction less than or equal to 15{\%}, pain upon cholecystokinin injection, and a family history of biliary disease were not predictors of symptomatic resolution. Nonoverweight patients (body mass index-for-age <85th percentile) were more likely to have symptom resolution than their overweight counterparts (odds ratio, 2.13). Most patients (68.3{\%}) had a pathologic gallbladder on blinded review. However, this did not correlate with outcome. Conclusions: Most gallbladders removed for biliary dyskinesia are pathologic. Being overweight can be considered a relative contraindication to cholecystectomy for biliary dyskinesia.",
keywords = "Acalculous biliary disease, Biliary dyskinesia, Laparoscopic cholecystectomy",
author = "Evan Brownie and Cusick, {Robert A.} and Perry, {Deborah A.} and Sandra Allbery and Azarow, {Kenneth S.}",
year = "2011",
month = "5",
day = "1",
doi = "10.1016/j.jpedsurg.2011.02.021",
language = "English (US)",
volume = "46",
pages = "879--882",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - Pathologic changes in biliary dyskinesia

AU - Brownie, Evan

AU - Cusick, Robert A.

AU - Perry, Deborah A.

AU - Allbery, Sandra

AU - Azarow, Kenneth S.

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Purpose: For children with upper abdominal pain and evaluation for acalculous biliary disease, laparoscopic cholecystectomy is an accepted treatment with inconsistent outcomes. The purpose of this study was to identify predictors of outcomes. Methods: One hundred sixty-seven children underwent laparoscopic cholecystectomy at a single children's hospital. Radiographic findings, histopathology, family history, and demographics (sex, age, height, weight, body mass index-for-age percentile) were evaluated as predictors of postoperative symptomatic resolution using a binomial probability model. The data for radiologic studies and pathologic specimens were obtained via re-review in a blinded fashion. Results: Of 167 children, 43 (25.7%) had a preoperative diagnosis of biliary dyskinesia and 41 (95.3%) had documented follow-up. Mean follow-up was 8.4 months. Twenty-eight patients (68.3%) had symptom resolution. Ejection fraction less than or equal to 15%, pain upon cholecystokinin injection, and a family history of biliary disease were not predictors of symptomatic resolution. Nonoverweight patients (body mass index-for-age <85th percentile) were more likely to have symptom resolution than their overweight counterparts (odds ratio, 2.13). Most patients (68.3%) had a pathologic gallbladder on blinded review. However, this did not correlate with outcome. Conclusions: Most gallbladders removed for biliary dyskinesia are pathologic. Being overweight can be considered a relative contraindication to cholecystectomy for biliary dyskinesia.

AB - Purpose: For children with upper abdominal pain and evaluation for acalculous biliary disease, laparoscopic cholecystectomy is an accepted treatment with inconsistent outcomes. The purpose of this study was to identify predictors of outcomes. Methods: One hundred sixty-seven children underwent laparoscopic cholecystectomy at a single children's hospital. Radiographic findings, histopathology, family history, and demographics (sex, age, height, weight, body mass index-for-age percentile) were evaluated as predictors of postoperative symptomatic resolution using a binomial probability model. The data for radiologic studies and pathologic specimens were obtained via re-review in a blinded fashion. Results: Of 167 children, 43 (25.7%) had a preoperative diagnosis of biliary dyskinesia and 41 (95.3%) had documented follow-up. Mean follow-up was 8.4 months. Twenty-eight patients (68.3%) had symptom resolution. Ejection fraction less than or equal to 15%, pain upon cholecystokinin injection, and a family history of biliary disease were not predictors of symptomatic resolution. Nonoverweight patients (body mass index-for-age <85th percentile) were more likely to have symptom resolution than their overweight counterparts (odds ratio, 2.13). Most patients (68.3%) had a pathologic gallbladder on blinded review. However, this did not correlate with outcome. Conclusions: Most gallbladders removed for biliary dyskinesia are pathologic. Being overweight can be considered a relative contraindication to cholecystectomy for biliary dyskinesia.

KW - Acalculous biliary disease

KW - Biliary dyskinesia

KW - Laparoscopic cholecystectomy

UR - http://www.scopus.com/inward/record.url?scp=79957541544&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957541544&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2011.02.021

DO - 10.1016/j.jpedsurg.2011.02.021

M3 - Article

C2 - 21616245

AN - SCOPUS:79957541544

VL - 46

SP - 879

EP - 882

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 5

ER -