Negative workup? Laparoscopic cholecystectomy Still alleviates symptoms - 18/03/24
Abstract |
Background |
Studies have shown that patients with abdominal pain and biliary dyskinesia (low ejection fraction <35 %) have significant improvement of symptoms following laparoscopic cholecystectomy, but there is lack of evidence that demonstrates whether patients with biliary symptoms and a normal ejection fraction (>35 %) will have similar results.
Methods |
Retrospective, single center study of patients with biliary pain and negative workup, including HIDA with EF>35 %, who were treated with laparoscopic cholecystectomy from 2017 to 2022.
Results |
There were 117 total patients. The mean age was 45.49 ± 15.5 years and 101 (86 %) were female. 101 (86 %) of patients underwent a right upper quadrant ultrasound, 91 had normal findings, 9 difficult to visualize anatomy and 1 had adenomyomatosis. All patients had a normal HIDA scan and ejection fraction 104 (89 %) of patients followed up in clinic within 30 days of surgical intervention. 87 (84 %) reported resolution of pre-operative symptomatology after surgical intervention. There was no statistically significant correlation between pain with CCK administration during HIDA (p = 0.803) scan or ejection fraction (p = 0.0977) with resolution of symptoms.
Conclusions |
Laparoscopic cholecystectomy appears to be a beneficial intervention for patients with abdominal pain and normokinetic biliary disease. Offering surgical intervention early on can potentially save patients from exhaustive diagnostic investigations and possibly misdiagnosis.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Ejection fraction is likely not as important as previously believed with >35 %. |
• | HIDA with CCK or Ensure administration is reliable indicator of disease. |
• | Disease treated with surgery often results in resolution of symptoms. |
Keywords : functional gallbladder disease, Laparoscopic cholecystectomy, HIDA, Biliary pain, Acalculous biliary pain
Plan
Vol 230
P. 39-42 - avril 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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