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A retrospective cohort study to examine the association between the persistence of abdominal pain after cholecystectomy and ejection fraction on HIDA scan in patients with biliary dyskinesia

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iLIVER 2023年第4期2卷 208-213页

作者： Baldeep Kaur Mann janpreet singh bhandohal Ishaan Kalha Brian Jean Department of Medicine Kern Medical Center1700 Mount Vernon Ave.BakersfieldCA 93306USA Division of Gastroenterology Department of MedicineKern Medical Center1700 Mount Vernon Ave.BakersfieldCA 93306USA Kern Medical Center 1700 Mount Vernon Ave.BakersfieldCA 93306USA

Background and aims:The persistence of pain in patients who underwent cholecystectomy primarily for biliary dyskinesia has been associated with gall bladder ejection fraction(GBEF)found on hepatobiliary iminodiacetic acid(HIDA)*** is a definitive treatment for cholelithiasis but is questionable in biliary *** the postoperative follow-up,gastroenterologists and surgeons often found that some patients with biliary dyskinesia continue to experience biliary pain even after *** study aims to investigate whether the value of GBEF found on the HIDA scan predicts the persistence of pain after cholecystectomy in patients with biliary dyskinesia(EF<35%on HIDA scan).Methods:It is a retrospective cohort study conducted at Kern Medical by recruiting patients from November 2019 to October 2022 in consecutive *** is a single sample study consisting of post-cholecystectomy biliary dyskinesia patients with dichotomous outcomes,i.e.,persistent typical recurrent epigastric or right upper quadrant pain with/without meals versus no *** primary outcome was the presence of pain 30 days after the *** analysis was performed with some of the bivariate indicators and continuous predictors,which contained fewer missing elements and had more ***:Univariate logistic regression suggested that HIDA GBEF as a continuous variable does not suggest a relationship with pain after surgery(p=0.3951).A ROC analysis suggested a cutoff of HIDA GBEF=16(AUC=0.60,Specificity=0.5455,Sensitivity=0.7333).Conclusion:Our study does not support the relationship between GBEF found on HIDA scan to improved outcomes after the *** larger controlled trials comparing outcomes of the patients with biliary dyskinesia who did and didn't undergo cholecystectomy are needed to look for other factors.

关键词： Post-cholecystectomy syndrome Biliary dyskinesia dyskinesia Gall bladder ejection fraction PCS HIDA Cholecystectomy

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