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- Title
Optimal Management of the Hyperkinetic Gallbladder: A Comparison of Outcomes Between Operative and Nonoperative Approaches.
- Authors
Williford, Michael L.; Fay, Katherine T.; Simpson, Francis J.; Defnet, Ann M.; Schuster, David M.; Sethi, Ila; Lin, Edward; Davis Jr., Steven Scott; Davis, Steven Scott Jr
- Abstract
<bold>Background: </bold>A hyperkinetic gallbladder is defined as a hepatobiliary iminodiacetic acid (HIDA) scan ejection fraction (EF) of >80%. This condition is poorly described, and there is no current consensus on optimal management. The intent of this study was to determine if cholecystectomy improves symptoms in patients with a hyperkinetic gallbladder when compared to those managed nonoperatively and if there were variables predictive of symptom improvement with or without cholecystectomy.<bold>Materials and Methods: </bold>This retrospective study included patients from 3 academic hospitals in the Atlanta metro area between the years 2006 and 2018. All patients with an EF >80% were included. Following voluntary exclusion patients were contacted by phone. Each patient was administered a questionnaire regarding their surgical history, medical management, and current symptom profile via Otago score. Institutional Institutional Review Board approval was obtained.<bold>Results: </bold>4785 HIDA scans were performed, and 194 reported an EF >80% (incidence 15.7%). 96% of these scans were reported as normal by the radiologist. 68 patients were able to be contacted by phone and completed the questionnaire. 18 patients underwent cholecystectomy, and 89% reported that their symptoms attributed to gallbladder disease were no longer present. 50 patients did not undergo cholecystectomy, and alternate diagnoses, medication prescriptions, diet modification, emergency department visits, and Otago score were higher in this cohort.<bold>Discussion: </bold>Patients who undergo cholecystectomy for a diagnosis of hyperkinetic gallbladder, on average, report improvement in symptoms when compared to patients managed nonoperatively. This study supports the practice of reporting and managing hyperkinetic gallbladders as a pathologic entity.
- Subjects
ATLANTA (Ga.); GEORGIA; GALLBLADDER cancer; CHOLECYSTECTOMY; GALLBLADDER; VENTRICULAR ejection fraction; INSTITUTIONAL review boards; DRUG prescribing; SYMPTOMS; RESEARCH; RESEARCH methodology; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; BILE duct diseases; COMPARATIVE studies; QUESTIONNAIRES
- Publication
American Surgeon, 2021, Vol 87, Issue 6, p903
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/0003134820966283