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Gallbladder dyskinesia

J Bart Rose, Ryan C Fields, Steven M Strasberg
BACKGROUND: Twenty percent of cholecystectomies in the US are performed for a diagnosis of biliary dyskinesia. Diagnosis is made by measuring gallbladder ejection fraction (GbEF) using hepatobiliary scintigraphy. Our purpose was to evaluate the reproducibility of GbEF measurements. STUDY DESIGN: This is a retrospective review of patients referred for cholecystectomy, from 2010 to 2016, with a diagnosis of biliary dyskinesia based on a GbEF test, who then underwent a repeat GbEF test...
February 2018: Journal of the American College of Surgeons
Thad Wilkins, Edward Agabin, Jason Varghese, Asif Talukder
The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct...
December 2017: Primary Care
Muhammad Shafqet, Kaveh Sharzehi
PURPOSE OF REVIEW: The emphasis of this review article is to bring to the forefront the spectrum of pancreatobiliary disorders and their association with diabetes. We hope to systematically discuss the link between diabetes and disorders of the pancreas including acute and chronic pancreatitis, as well as pancreatic cancer. We also hope to review and highlight the literature with respect to other cancers of the biliary tree including gallbladder and cholangiocarcinoma. Lastly, we discuss diabetes and biliary dyskinesia...
December 2017: Current Treatment Options in Gastroenterology
Brian P Blackwood, Julia Grabowski
AIM: We hypothesize that chronic cholecystitis accounts for the majority of inflammatory diseases in the pediatric population and it is difficult to predict with preoperative ultrasound. BACKGROUND: Despite the increase in gallbladder disease, there is a paucity of data on pediatric cholecystitis. Most pediatric studies focus on cholelithiasis and biliary dyskinesia rather than inflammatory gallbladder disease. METHODS: We performed a single center retrospective review of all patients who underwent cholecystectomy from 1/1/10 - 1/1/15...
2017: Gastroenterology and Hepatology From Bed to Bench
Warapan Nakayuenyongsuk, Hassan Choudry, Karla Au Yeung, Wikrom Karnsakul
AIM: To explore and to analyze the patterns in decision-making by pediatric gastroenterologists in managing a child with a suspected diagnosis of functional gallbladder disorder (FGBD). METHODS: The questionnaire survey included a case history with right upper quadrant pain and was sent to pediatric gastroenterologists worldwide via an internet list server called the PEDGI Bulletin Board. RESULTS: Differences in decision-making among respondents in managing this case were observed at each level of investigations and management...
May 8, 2017: World Journal of Clinical Pediatrics
Sung Won Jung, Min Sun Joo, Hyun Chang Choi, Sung Ill Jang, Young Sik Woo, Jin Bae Kim, Sang Hoon Park, Myung Seok Lee
Functional dyspepsia (FD) is a constellation of epigastric symptoms originating in the gastroduodenal region without organic and metabolic cause. However, similar confounding symptoms can also appear in patients with gallbladder (GB) dyskinesia. Therefore, symptoms of GB dyskinesia may be mistaken for FD. We aimed to identify GB dyskinesia as a cause of FD symptoms compatible with the Rome IV criteria and the need for an evaluation of GB function in patients with FD symptoms.We investigated information of patients with FD symptoms who underwent a quantitative Tc-diisoproyl iminodiacetic acid cholescintigraphy (DISIDA scan) through electronic medical records, and GB dyskinesia was judged to be the cause of the FD symptoms if the symptoms disappeared as GB function normalized on the follow-up DISIA scan in patient with decreased GB function on the initial DISIDA scan...
April 2017: Medicine (Baltimore)
Sarah W Lai, Steven S Rothenberg, Saundra M Kay, Kristin E Shipman, Bethany J Slater
PURPOSE: To determine the outcomes of laparoscopic cholecystectomy as a treatment for biliary dyskinesia in children. METHODS: With ethics approval, a retrospective chart review was performed on children (<21 years) at a single center diagnosed with biliary dyskinesia (defined as gallbladder ejection fraction [EF] <35% and/or pain with cholecystokinin [CCK] on cholescintigraphy, in the absence of gallstones or cholecystitis on ultrasound) and treated with laparoscopic cholecystectomy between March 2010 and February 2016...
August 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
David H Rothstein, Carroll M Harmon
Biliary disease in children has changed over the past few decades, with a marked rise in incidence-perhaps most related to the parallel rise in pediatric obesity-as well as a rise in cholecystectomy rates. In addition to stone disease (cholelithiasis), acalculous causes of gallbladder pain such as biliary dyskinesia, also appear to be on the rise and present diagnostic and treatment conundrums to surgeons.
August 2016: Seminars in Pediatric Surgery
Neha R Santucci, Paul E Hyman, Carroll M Harmon, Julie H Schiavo, Sunny Z Hussain
Cholecystectomy rates for biliary dyskinesia in children are rising in the United States, but not in other countries. Biliary dyskinesia is a validated functional gallbladder disorder in adults, requiring biliary colic in the diagnosis. In contrast, most studies in children require upper abdominal pain, absent gallstones on ultrasound, and an abnormal gallbladder ejection fraction (GBEF) on cholecystokinin-stimulated cholescintigraphy for diagnosis. We aimed to systematically review existing literature in biliary dyskinesia in children, determine the validity and reliability of diagnostic criteria, GBEF, and to assess outcomes following cholecystectomy...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
Keith K Lai, Hannah E Goyne, David Hernandez-Gonzalo, Kennon A Miller, Marion Tuohy, Gary W Procop, Laura W Lamps, Deepa T Patil
Cystoisospora belli, previously known as Isospora belli, is an obligate intracellular coccidian parasite that is most often associated with gastrointestinal disease in immunocompromised patients. In this study, we detail the clinicopathologic features of 18 cases of Cystoisospora infection affecting the gallbladder in immunocompetent individuals and compare them with a control group. Each case was reviewed for cholecystitis (none, acute, chronic), epithelial disarray, presence of intraepithelial lymphocytes (none, rare [≤5 per 20 epithelial cells], present [>5 per 20 epithelial cells]), architectural distortion, intramucosal eosinophilia, and mural thickening/serositis...
August 2016: American Journal of Surgical Pathology
Bryan K Richmond, Caresse Grodman, Jerri Walker, Scott Dean, Edward H Tiley, Roland E Hamrick, Kristen Statler, Mary Emmett
BACKGROUND: Despite widespread adoption by the surgical community, high-quality prospective data supporting the practice of laparoscopic cholecystectomy (LC) for the treatment of biliary dyskinesia (BD) are lacking. STUDY DESIGN: Adult patients meeting criteria for diagnosis of BD (Rome III symptoms, normal ultrasound, gallbladder ejection fraction < 38%) were randomized to either LC or a trial of nonoperative (NO) therapy with a low-dose neuromodulator (amitriptyline 25 mg/day)...
June 2016: Journal of the American College of Surgeons
Saif Dairi, Andrew Demeusy, Anne M Sill, Shirali T Patel, Gopal C Kowdley, Steven C Cunningham
BACKGROUND: The clinical significance of cholesterolosis has not been well established but there are some provocative, if not robust, studies of the role it may play in the pathophysiology of pancreatitis and biliary dyskinesia, as well as hypercholesterolemia. Our aim was to take advantage of a very large cholecystectomy (CCY) database to support or refute these potentially important reported associations. MATERIALS AND METHODS: A retrospective review of 6868 patients who underwent CCY from 2001-2013 was performed...
February 2016: Journal of Surgical Research
Amanda H Eckenrode, Joseph A Ewing, Jennifer Kotrady, Allyson L Hale, Dane E Smith
Patients with upper abdominal pain, nausea, and vomiting are often evaluated with ultrasound to diagnose symptomatic cholelithiasis or cholecystitis. With a normal ultrasound, a hepatobiliary iminodiacetic acid (HIDA) scan with ejection fraction (EF) is recommended to evaluate gallbladder function. The purpose of this study was to evaluate whether the HIDA scan with EF was appropriately utilized in considering cholecystectomy. Over 18 months, we performed 1533 HIDA scans with EF. After exclusion, 1501 were analyzable, 438 of whom underwent laparoscopic cholecystectomy...
July 2015: American Surgeon
Hideo Takahashi, Gavin A Falk, Michael Cruise, Gareth Morris-Stiff
A 47-year-old woman presented with a history of vague abdominal pain for several years, which worsened over the past 2 months, with pain more prominent in the right upper quadrant. She also had a history of peptic ulcer disease. The ultrasound scan of right upper quadrant revealed normal gallbladder and oesophagogastroduodenoscopy was unremarkable. A (99m)technetium labelled hepato iminodiacetic acid (HIDA) scan with cholecystokinin provocation demonstrated a decreased gallbladder ejection fraction (EF) of 32%...
June 11, 2015: BMJ Case Reports
Jacob A Hessey, Laura Halpin, Kerri A Simo
INTRODUCTION: Suprahepatic gallbladders have been reported in the literature dating back to 1965. However, their etiology and consequences remain unclear. METHODS: A case of a patient being treated for biliary dyskinesia with an incidental finding of suprahepatic gallbladder is presented along with a literature review on the causes, effects, and management of a suprahepatic gallbladder. DISCUSSION: Patient underwent a robotic-assisted laparoscopic cholecystectomy without complications and had an uneventful recovery...
July 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
R V Dave, S Pathak, A J Cockbain, J P Lodge, A M Smith, F U Chowdhury, G J Toogood
AIMS: To evaluate clinical outcomes in patients with typical biliary pain, normal ultrasonic findings, and a positive (99m)technetium (Tc)-labelled hepatic iminodiacetic acid analogue (HIDA) scintigraphy with cholecystokinin (CCK) provocation indicating gallbladder dyskinesia, as per Rome III criteria, undergoing laparoscopic cholecystectomy (LC). METHODS AND MATERIALS: Consecutive patients undergoing LC for gallbladder dyskinesia were identified retrospectively...
April 2015: Clinical Radiology
Salman Nusrat, Sultan Mahmood, Donald Kastens, Klaus Bielefeldt
OBJECTIVES: Biliary dyskinesia and gastroparesis are associated with upper abdominal discomfort and dyspeptic symptoms in the absence of structural abnormalities. We hypothesized that the similarity in symptoms would trigger testing and surgical treatment for biliary abnormalities in a significant number of patients, with refractory symptoms ultimately demonstrating impairment of gastric function. METHODS: The study was designed as a retrospective review of patients seen between April 1, 2008 and December 31, 2009...
December 2014: Southern Medical Journal
Jeong Kyong Lee, Yookyung Kim, Sangmin Lee, Ji Eun Park
OBJECTIVE: To compare hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance (HMR) and hepatobiliary scintigraphy (HBS) for evaluation of cystic duct patency and gallbladder contractility in patients suspected of having gallbladder dyskinesia. MATERIALS AND METHODS: Eighteen patients underwent HMR and HBS. Cystic duct patency and gallbladder ejection fraction (GBEF) were compared to determine a significant difference between HMR and HBS. RESULTS: HMR and HBS had 15 concordant and 3 discordant results for cystic duct patency...
January 2015: Clinical Imaging
G Mennuni, L Petraccia, M Fontana, S Nocchi, E Stortini, M Romoli, E Esposito, F Priori, M Grassi, A Geraci, A Serio, A Fraioli
BACKGROUND AND AIM: Functional disorders of the biliary tract involve gallbladder and sphincter of Oddi and cause pain and/or digestive troubles. In this context, in addition to pharmacological treatments, an important role is played by the use of sodium-sulphate and sulphate-bicarbonate mineral waters that, because of their composition into ions macro and trace elements, can stimulate the release or modulate the activity of some neurohumoral regulators of the digestive process. We want to do a study on the effects of hydropinotherapy with a sulphate-bicarbonate-calcium-magnesium mineral water in patients suffering from pain and other symptoms caused by biliary dyskinesias, biliary sand (without gallstones), or following a cholecystectomy (post-cholecystectomy syndromes)...
2014: La Clinica Terapeutica
Takamitsu Sasaki, Daisuke Kato, Satoshi Shinya, Ryo Nakashima, Hironari Shiwaku, Kanefumi Yamashita, Yuichi Yamashita
A 75-year-old woman entered the hospital emergency room complaining of severe epigastric pain. She had experienced similar repeated abdominal pain for some time. Biliary tract dyskinesia was suspected based on the Roma III criteria. When drip infusion cholangiography-CT with egg yolk load was performed, the contraction rate of the gallbladder before and after applying the load was as low as 33.5%. Upon biliary tract scintigraphy, biliary excretion into the intestinal tract was found to be normal, but after the egg yolk load, the biliary excretion rate in the gallbladder decreased to 14...
November 2014: Asian Journal of Endoscopic Surgery
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