Therapeutic efficacy of laparoscopic cholecystectomy in the treatment of biliary dyskinesia

Background: The outcome of laparoscopic cholecystectomy for patients who present with "classic" biliary colic without evidence of cholelithiasis or acute inflammation (biliary dyskinesia) is not well documented. This study evaluates whether a cholecystokinin dimethyl immodiacetic acid (CCK-HIDA) scan can predict relief of symptoms in this group of patients. Methods: Patients who underwent laparoscopic cholecystectomy after a normal ultrasound and with an abnormal dimethyl iminodiacetic acid scan were retrospectively reviewed. Symptomatic improvement was correlated with degree of dyskinesia, histologic findings, sex, and age. Results: One hundred seventy-six patients were studied and 69% were available for followup at a mean interval of 16 months. One hundred fourteen patients (94%) had complete or partial relief of symptoms. No correlation was found between degree of relief and degree. of impaired ejection (31% to 50% versus <30%), the histologic findings, sex, or age. Conclusions: Abnormal cholecystokinin dimethyl iminodiacetic acid scan effectively predicts relief of symptoms in patients undergoing laparoscopic cholecystectomy for biliary dyskinesia. (C) 2004 Excerpta Medica, Inc. All rights reserved.