Nilesh A. Patel, M.D., Jason J. Lamb, M.D., Nancy Hogle, R.N., Dennis L. Fowler, M.D.

Design: All patients undergoing LC at a single institution between October 1996 and June 1999 were retrospectively reviewed. Patients who had a preoperative workup that included a positive HIDA scan (gallbladder ejection fraction [GBEF] <50%) were selected from this group of patients. Symptomatic improvement was then correlated to the degree of dyskinesia, gender, final pathology results, and normal or abnormal findings on preoperative ultrasound.

Results: Two hundred seventy-three patients had preoperative HIDA scans of which 204 revealed GBEF <50%. Of these patients, 148 (73%) were available for follow-up (mean of 16 months) and were divided into two groups. Group I (n = 121) were patients with GBEF <50% and a normal ultrasound (biliary dyskinesia) and Group II (n = 27) were patients with GREF of <50% and a positive ultrasound (cholelithiasis or biliary sludge). One hundred fourteen patients (94%) in Group I and 25 (93%) patients in Group II had complete or partial relief of their preoperative symptoms.

Conclusions: LC is a highly effective treatment for symptoms caused by biliary dyskinesia. The effectiveness of LC for biliary dyskinesia is not altered by the presence of stones or sludge in the gallbladder on ultrasound exam, pathologic findings on final pathology report or the degree of biliary dyskinesia. Females have better symptorfiatic relief than males after LC performed for biliary dyskinesia.



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