Journal of Gastrointestinal Surgery

, Volume 16, Issue 1, pp 135–141 | Cite as

Biliary Dyskinesia: How Effective is Cholecystectomy?

  • Vikas SinghalEmail author
  • Patrick Szeto
  • Heather Norman
  • Nan Walsh
  • Burt Cagir
  • Thomas J. VanderMeer
2011 SSAT Plenary Presentation



Studies on biliary dyskinesia have been based on short-term surgical follow-up and do not take into consideration that most patients are discharged from surgical follow-up after the first postoperative visit and that for persistent or recurrent symptoms they are frequently seen by primary care providers and subsequently referred to gastroenterologists. We aimed to study this pattern and assess which factors predict patients that will benefit from cholecystectomy.


This is a retrospective analysis of medical records of patients who underwent cholecystectomy for biliary dyskinesia from February 2001 to January 2010 with a minimum postoperative follow-up of 6 months.


At initial surgical follow-up, 19 of 141 (13.4%) patients said they had persistent symptoms. However, when subsequent visits were analyzed, 61 of 141 (43.3%) patients with persistent or recurrent symptoms saw their primary care provider. These symptoms were epigastric or right upper quadrant pain in 43 patients or 30% of those undergoing cholecystectomy. The only factor that distinguished patients with and without resolution of symptoms after cholecystectomy was the pathologic finding of inflammation (p = 0.02).


Cholecystectomy does not appear to be as effective for biliary dyskinesia when long-term follow-up is evaluated.


Biliary dyskinesia Cholecystectomy HIDA scan CCK stimulation Endoscopy 




Conflicts of Interest



  1. 1.
    Hansel SL, DiBaise JK. Functional gallbladder disorder: gallbladder dyskinesia. Gastroenterol Clin North Am 2010; 39(2):369–79, x. PubMedCrossRefGoogle Scholar
  2. 2.
    Tulchinsky M. Diagnosis of BD relied in great measure on gallbladder ejection fraction (GBEF) after sincalide stimulation on hepatobiliary scintigraphy. J Pediatr Surg 2009; 44(10):2059–60. PubMedCrossRefGoogle Scholar
  3. 3.
    Gurusamy KS, Junnarkar S, Farouk M, Davidson BR. Cholecystectomy for suspected gallbladder dyskinesia. Cochrane Database Syst Rev 2009;(1):CD007086.Google Scholar
  4. 4.
    Vassiliou MC, Laycock WS. Biliary dyskinesia. Surg Clin North Am 2008; 88(6):1253-ixCrossRefGoogle Scholar
  5. 5.
    Goncalves RM, Harris JA, Rivera DE. Biliary dyskinesia: natural history and surgical results. Am Surg 1998; 64(6):493–7.PubMedGoogle Scholar
  6. 6.
    Richmond BK. Response to: Laparoscopic cholecystectomy is safe and effective for the treatment of biliary dyskinesia in the pediatric population. Am Surg 2010; 76(12):1426.PubMedGoogle Scholar
  7. 7.
    Hofeldt M, Richmond B, Huffman K, Nestor J, Maxwell D. Laparoscopic cholecystectomy for treatment of biliary dyskinesia is safe and effective in the pediatric population. Am Surg 2008; 74(11):1069–72.PubMedGoogle Scholar
  8. 8.
    Constantinou C, Sucandy I, Ramenofsky M. Laparoscopic cholecystectomy for biliary dyskinesia in children: report of 100 cases from a single institution. Am Surg 2008; 74(7):587–92.PubMedGoogle Scholar
  9. 9.
    Halata MS, Berezin SH. Biliary dyskinesia in the pediatric patient. Curr Gastroenterol Rep 2008; 10(3):332–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Haricharan RN, Proklova LV, Aprahamian CJ et al. Laparoscopic cholecystectomy for biliary dyskinesia in children provides durable symptom relief. J Pediatr Surg 2008; 43(6):1060–4.PubMedCrossRefGoogle Scholar
  11. 11.
    Vegunta RK, Raso M, Pollock J et al. Biliary dyskinesia: the most common indication for cholecystectomy in children. Surgery 2005; 138(4):726–31.PubMedCrossRefGoogle Scholar
  12. 12.
    Morris-Stiff G, Falk G, Kraynak L, Rosenblatt S. The cholecystokin provocation HIDA test: recreation of symptoms is superior to ejection fraction in predicting medium-term outcomes. J Gastrointest Surg 2011; 15(2):345–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Krishnamurthy GT, Krishnamurthy S. Extended application of 99mTc-mebrofenin cholescintigraphy with cholecystokinin in the evaluation of abdominal pain of hepatobiliary and gastrointestinal origin. Nucl Med Commun 2010; 31(5):346–54.PubMedGoogle Scholar
  14. 14.
    Velanovich V. Biliary dyskinesia and biliary crystals (a prospective study). Am Surg. 1997;63:69–74PubMedGoogle Scholar
  15. 15.
    Tierney S, Pitt HA, Lillemoe KD. Physiology and pathophysiology of gallbladder motility. Surg Clin North Am. 1993 Dec;73(6):1267–90.PubMedGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • Vikas Singhal
    • 1
    Email author
  • Patrick Szeto
    • 1
  • Heather Norman
    • 1
  • Nan Walsh
    • 1
  • Burt Cagir
    • 1
  • Thomas J. VanderMeer
    • 1
  1. 1.Department of SurgeryGuthrie-Robert Packer HospitalSayreUSA

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