Sharrak A, Aubrey J, Hua T, Wang S, Zambito G, Banks-Venegoni A. Negative workup? Laparoscopic cholecystectomy Still alleviates symptoms.
Am J Surg 2024;
230:39-42. [PMID:
38052669 DOI:
10.1016/j.amjsurg.2023.11.035]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/07/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
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.
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