Cholecystectomy is commonly performed electively for symptomatic cholelithiasis and biliary hypokinesia with an ejection fraction (EF) less than 35%. Recent literature has shown that cholecystectomy in adults for biliary hyperkinesia (EF>65%) can provide resolution of symptoms (primarily pain) for the majority of patients. We seek to determine whether cholecystectomy is efficacious in the treatment of symptomatic biliary hyperkinesia in the pediatric population.
The charts of over 100 patients aged 7 to 21 in the last 10 years (2008 to 2018) who had cholecystectomies were reviewed to determine ejection fraction, BMI, race, pain with CCK-HIDA, complications, and resolution of symptoms (pain, vomiting, steatorrhea, diarrhea) post operatively. Analyses of surgical outcomes were performed between two groups, low/normal EF and high EF, which were stratified and compared.
A total of 79 patients had low/normal EF (EF <65%), and 26 had high EF (EF>65%). Mann-Whitney, Chi-square, & Fisher’s exact tests differentiated between groups. The resolution of symptoms rate was similar between groups with no statistical difference: low/normal EF (75%) vs. high EF (69%), p=0.497. Pain with HIDA scan appeared higher in the high EF group (p=0.047), refer to Table 1. No difference was shown between groups for gender, race, age, BMI, and follow-up rates. No surgical complications were seen in either group.
Pediatric patients with symptomatic biliary hyperkinesia experience a similar rate of resolution of their symptoms when compared to similarly matched patients who underwent cholecystectomy for biliary hypokinesia.
Dighamber, S., Herzing, K., Aranda, A., Pence, J. C., & Barnett, S. (2021). Outcomes in Children and Adolescents Undergoing Cholecystectomies with a High Ejection Fraction. Wright State University. Dayton, Ohio.