학술논문

Laparoscopic cholecystectomy for biliary dyskinesia: Which patients have long term benefit?
Document Type
Academic Journal
Source
Surgery. Oct 01, 2013 154(4):761-768
Subject
Language
English
ISSN
0039-6060
Abstract
PURPOSE: METHODS: A retrospective review was performed at a single institution of all patients who underwent LC for BD from January 2005 through January 2012. The diagnosis of BD was determined by a normal gallbladder as viewed with ultrasonography and cholescintigraphy with a gallbladder EF less than or equal to 45%. Data collection included demographics, results of imaging studies, pathologic diagnosis, and early postoperative pain relief. Patients were contacted by phone after being discharged from the surgeonʼs care for evaluation of symptom relief. Data were analyzed with nonparametric statistical methods, including Mann–Whitney U test, receiver operator characteristic, Fisher exact test, and χ test. All data are expressed as median and 25th and 75th percentile range. RESULTS: There were 126 patients who had a LC for BD during the study period. The median biliary EF was 20% (10−29%). The most common pathologic finding was chronic cholecystitis (n = 95; 75%). Median length of follow-up in the perioperative period was 11 days (8−17), during which time 98 patients (78%) had relief of symptoms. Phone interviews (n = 53; 42%) confirmed 66% (n = 35) of patients remained free of pain. There was no difference in the mean EF among those with resolution of pain 20% (10−29%) compared with patients with persistent pain 23% (11−29%), P = .62. Obese patients were more likely to have persistent symptoms in the perioperative period with a shift to lower body mass index at the time of the phone survey. Receiver operator characteristic characteristic for the association between scintigraphic EF and resolution of postoperative pain demonstrated no association, with the area under the curve equal to 0.47. CONCLUSION