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Biliary Dyskinesia and Hyperkinesis.
Surg Clin North Am
December 2024
Department of Medicine, CSC Health, 767 North Hill Street Suite 200, Los Angeles, CA 90012, USA.
Biliary dyskinesia refers to a group of functional and motility disorders of the biliary system in patients presenting with typical biliary pain, but without any visible structural abnormalities on standard imaging. The Rome IV Criteria establishes diagnostic criteria for functional gallbladder disorder (gallbladder dyskinesia and biliary hyperkinesia), functional biliary sphincter of Oddi disorder (biliary dyskinesia), and pancreatic sphincter of Oddi disorder. Many diagnostic adjuncts such as hepatobiliary scintigraphy and sphincter of Oddi manometry exist, although these results are supportive and not necessarily diagnostic for biliary dyskinesia.
View Article and Find Full Text PDFEvaluation and Management of Biliary Dyskinesia in Children and Adolescents: A Systematic Review From the APSA Outcomes and Evidence-Based Committee.
J Pediatr Surg
November 2024
Division of Pediatric Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Article Synopsis
- The diagnosis and management of biliary dyskinesia in children and adolescents is inconsistent, prompting a systematic review by the American Pediatric Surgical Association to create evidence-based recommendations.
- The review focused on key areas such as diagnostic criteria, the need for cholecystectomy, and outcomes from surgical vs. non-surgical management, but found that diagnostic criteria are unclear and reliable predictors of treatment success are lacking.
- Pediatric-specific guidelines are needed to clarify this condition, improve diagnostic processes, and determine effective management, along with calls for more prospective studies to identify which patients could benefit from surgery.
Defining Biliary Hyperkinesia and the Role of Cholecystectomy.
J Am Coll Surg
November 2023
Departments of Surgery (Jorge, Webb, Madura), Mayo Clinic, Phoenix, AZ.
Background: Functional gallbladder disorder is most commonly defined by biliary colic and low ejection fraction (EF) on cholescintigraphy. Biliary hyperkinesia is a controversial type of functional gallbladder disorder, and its definition and the role of cholecystectomy in treating functional gallbladder disorder remains unclear.
Study Design: We conducted a retrospective review of patients who underwent cholecystokinin-stimulated cholescintigraphy and cholecystectomy at 3 Mayo Clinic sites between 2007 and 2020.
Biliary Hyperkinesia and Its Association With Bariatric Surgery: A Case Report and Review of Management Strategies.
Cureus
January 2023
Department of General Surgery, West Suburban Medical Center, Chicago, USA.
In a post-bariatric surgery patient with suspected biliary dyskinesia, what does an ejection fraction (EF) of 87% on hepatobiliary iminodiacetic acid (HIDA) scan indicate to a healthcare provider? Conventionally, in post-bariatric patients, the gallbladder becomes hypofunctional; however, in this case, the gallbladder activity increased exponentially. Of note, there are no previously documented cases of developing an overactive gallbladder after undergoing a bariatric surgery procedure. This report aims to explore the possible associations between bariatric surgery and the development of gallbladder hyperkinesis in the early postoperative period, the diagnostic tool used to discover the source of our patient's ailment, as well as the rationality behind a surgical procedure that led to an excellent response, namely, laparoscopic cholecystectomy.
View Article and Find Full Text PDFBiliary hyperkinesia in adolescents-it isn't all hype!
Transl Gastroenterol Hepatol
July 2021
Section of Pediatric Surgery, Wake Forest Baptist Medical Center, Brenner Children's Hospital, Winston-Salem, NC, USA.
Background: Biliary dyskinesia generally refers to a hypofunctioning gallbladder with an ejection fraction (EF) of <35% on hepatobiliary iminodiacetic acid scan with cholecystokinin stimulation (CCK-HIDA testing). In adults, biliary hyperkinesia has a defined association with biliary colic symptoms and can be relieved with surgical intervention. This clinical entity has not been well described in children or adolescents.
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