Abstract
Functional gallbladder disorder refers to biliary-like pain in the absence of structural disease. It is a controversial condition and has many aliases including acalculous biliary disease, acalculous gallbladder dysfunction, biliary dyskinesia, chronic acalculous gallbladder dysfunction, and gallbladder dyskinesia. The multitude of names is likely a direct reflection of the difficulty defining this disorder and understanding its pathogenesis. In fact, there is not a specific ICD-9 code for functional gallbladder disorder. Despite these difficulties, this constellation of symptoms is very relevant as it is frequently encountered in medical and surgical practices. The Rome committee has attempted to standardize the definition of biliary pain and criteria for the diagnosis of functional gallbladder disorder; however, due to significant overlap with other functional gastrointestinal disorders, continued confusion persists.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Key References
Behar J, Corazziari E, Guelrud M, Hogan W, Sherman S, Toouli J. Functional gallbladder and sphincter of Oddi disorders. Gastroenterology. 2006;130(5):1498–509. Provides a description of the most recent Rome criteria for the diagnosis of functional gallbladder disorder.
Bielefeldt K. The rising tide of cholecystectomy for biliary dyskinesia. Aliment Pharmacol Ther. 2013;37(1):98–106. Recent article exploring trends in cholecystectomy use in the United States.
Delgado-Aros S, Cremonini F, Bredenoord AJ, Camilleri M. Systematic review and meta-analysis: does gallbladder ejection fraction on cholecystokinin cholescintigraphy predict outcome after cholecystectomy in suspected functional biliary pain? Aliment Pharmacol Ther. 2003;18:167–74. Systematic review and meta-analysis showing data that do not support the use of GBEF to select patients with suspected functional biliary pain for cholecystectomy.
DiBaise JK, Richmond BK, Ziessman HH, Everson GT, Fanelli RD, Maurer A, et al. Cholecystokinin-cholescintigraphy in adults: consensus recommendations of an interdisciplinary panel. Clin Gastroenterol Hepatol. 2011;9(5):376–84. Defines the optimal method for performing CCK-CS and addresses limitations of the test.
Gurusamy KS, Junnarkar S, Farouk M, Davidson BR. Cholecystectomy for suspected gallbladder dyskinesia. Cochrane Database Syst Rev. 2009;(1):CD007086. doi:10.1002/14651858.CD007086.pub2. Cochrane review highlighting that the evidence for the benefits and harms of cholecystectomy in gallbladder dyskinesia from randomized clinical trials is based on a single small trial at high risk of bias.
Yap L, Wycherly AG, Morphett AD, et al. Acalculous biliary pain: cholecystectomy alleviates symptoms in patients with abnormal cholescintigraphy. Gastroenterology. 1991;101(3):786–93. Only prospective, controlled study of cholecystectomy in patients with suspected functional gallbladder disorder.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Teaching Questions
Teaching Questions
-
1.
A 35-year-old female is referred to you for evaluation of episodic right upper quadrant pain. The pain is intermittent without radiation. She is unaware of any triggers for the pain. There are no associated symptoms or weight loss. Which test is not necessary at this point?
-
(A)
Liver and pancreatic enzymes
-
(B)
Transcutaneous abdominal ultrasound
-
(C)
Esophagogastroduodenoscopy
-
(D)
CT scan abdomen and pelvis
-
(A)
-
2.
Aside from functional gallbladder disorder, conditions that may lead to a decreased gallbladder ejection fraction include all of the following EXCEPT:
-
(A)
Celiac disease
-
(B)
Chronic narcotic use
-
(C)
Functional sphincter of Oddi disorder
-
(D)
Diabetes mellitus
-
(A)
-
3.
Which of the following patients would seem to be the best candidate for referral for a laparoscopic cholecystectomy?
-
(A)
A 25-year-old female with severe bloating and nausea and constant right upper quadrant abdominal pain with a GBEF of 27 %
-
(B)
A 50-year-old female with severe intermittent right quadrant pain and a GBEF of 21 %
-
(C)
A 25 year-old male with severe intermittent right upper quadrant pain on chronic oxycodone with a GBEF of 35 %
-
(D)
A 35 year-old female with severe intermittent right upper quadrant pain and a GBEF of 78 % who has been seen in the emergency room on a repeated basis for pain control
-
(A)
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Hansel, S.L. (2015). Functional Gallbladder Disorder. In: Lacy, B., Crowell, M., DiBaise, J. (eds) Functional and Motility Disorders of the Gastrointestinal Tract. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1498-2_13
Download citation
DOI: https://doi.org/10.1007/978-1-4939-1498-2_13
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-1497-5
Online ISBN: 978-1-4939-1498-2
eBook Packages: MedicineMedicine (R0)