• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Biliary Dyskinesia: A Myth or a real Disease entity One surgeon’s experience in Mid Ohio Valley.

Emmanuel A Agaba, MD, Alyse McNeill, PAC, MSPAS. Marietta Memorial Hopsital, Marietta OH

Increasingly, more patients with gallbladder and biliary dyskinesia are being recognized in United States. Although improved technology may be responsible for this increase, it is questionable whether this alone maybe responsible for the surge in the diagnosis.

Biliary dyskinesia is a diagnosis of exclusion, and the symptoms associated with functional gallbladder disorder may mimic symptoms seen in patients with various disorders, including peptic ulcer disease, ischemic heart disease, and functional dyspepsia.

This study aims at reviewing one surgeon’s experience with this complex disease entity.

Methods: Between April 2014 and June 2016, all patients with right upper quadrant pain that occurs for at least 30 minutes at variable intervals in the absence of gallstones or other structural abnormalities and sufficient to warrant emergent room visit. Importantly, the patient’s pain is not significantly relieved by bowel movements, acid suppression or postural changes. All patients had normal liver enzymes, conjugated bilirubin and lipase/amylase.

To qualify CCK-stimulated cholescintigraphy is used to estimate the gallbladder ejection fraction (GBEF).

In preparation, following an overnight fast, 99mTc-diisopropyl-iminodiacetic acid (DISIDA) or 99mTc-hepatic iminodiacetic acid (HIDA) is given as an intravenous bolus. After 45 to 90 minutes, baseline radioactivity from the region of the gallbladder is measured. When the radioactivity is maximal from the gallbladder and is minimal from the liver, a slow infusion of CCK is started to stimulate gallbladder contraction, which leads to expulsion of the radio labeled tracer (Sincalide 0.02mcg/kg given over 30 to 60 minutes).

A diagnosis of biliary dyskinesia is made if the GBEF was less than 40%

All these patients were offered laparoscopic cholecystectomy. Dataset was collected prospectively.

Results: Ninety-seven patients met the diagnostic criteria. All patients had negative transabdominal ultrasonographic and computed axial tomographic scans as well as upper gastrointestinal endoscopy. All patients were offered laparoscopic cholecystectomy and were followed for 6 months. During postoperative visits, the patients were asked specifically for resolution of their symptoms. Eighty-two patients have complete disease resolution, 10 patients continued to have persistent pain while 4 patients had persistent diarrhea. One patient was lost to follow up after 3 months.

Conclusions: Although more patients are presenting with biliary dyskinesia, some authorities have questioned the validity of such a disease entity; our study has shown that biliary dyskinesia is a true disease that is remediable by surgical intervention.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 78973

Program Number: P095

Presentation Session: Poster (Non CME)

Presentation Type: Poster

698

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2017 abstract archive

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
sagesweb@sages.org
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons