Pathologic changes in biliary dyskinesia

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

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


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
Issue number5
StatePublished - May 2011


  • Acalculous biliary disease
  • Biliary dyskinesia
  • Laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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