PMID- 19221331
OWN - NLM
STAT- MEDLINE
DCOM- 20090312
LR  - 20161125
IS  - 1538-3644 (Electronic)
IS  - 0004-0010 (Linking)
VI  - 144
IP  - 2
DP  - 2009 Feb
TI  - Meta-analysis of cholecystectomy in symptomatic patients with positive 
      hepatobiliary iminodiacetic acid scan results without gallstones.
PG  - 180-7
LID - 10.1001/archsurg.2008.543 [doi]
AB  - OBJECTIVE: To study the clinical results of surgical management in patients with 
      right upper quadrant pain, a positive hepatobiliary iminodiacetic acid (HIDA) 
      scan result, and no gallstones. DATA SOURCES: Health care databases and gray 
      literature. STUDY SELECTION: Each article was scrutinized to determine whether it 
      met inclusion criteria. Only abstracts, full articles, and gray literature that 
      passed the detailed screening procedure were included. Case reports, letters, 
      comments, reviews, and abstracts with insufficient details to meet inclusion 
      criteria were excluded. Gallbladder ejection fraction assessed by means other 
      than cholecystokinin HIDA scan were also excluded. DATA EXTRACTION: Three 
      reviewers independently abstracted the following data from each article: first 
      author, year of publication, journal, type of study, location of study 
      population, institution where the study was conducted, symptoms recorded, imaging 
      modality used to establish the absence of gallstones, HIDA scan ejection 
      fraction, number of cases and controls, number of males and females in each 
      group, method of follow-up, and number of cases lost to follow-up. DATA 
      SYNTHESIS: Ten studies met inclusion criteria (N = 615). Follow-up ranged from 3 
      to 64 months. Surgical treatment was 15-fold more likely than medical treatment 
      to result in symptom improvement, with 4% of patients reporting no symptom 
      improvement with surgery. Sensitivity analysis in patients with complete symptom 
      relief following surgery revealed an 8-fold greater odds difference than those 
      treated medically (indicating variation in study reporting). CONCLUSIONS: 
      Patients without gallstones who have right upper quadrant pain and a positive 
      HIDA scan result are more likely to experience symptom relief following 
      cholecystectomy than those treated medically. There is, however, wide variability 
      in data reporting, particularly with respect to symptom relief and duration of 
      follow-up. Cholecystectomy is indicated in symptomatic patients without 
      gallstones who have a low-ejection fraction HIDA scan.
FAU - Mahid, Suhal S
AU  - Mahid SS
AD  - Price Institute of Surgical Research and the Section of Colorectal Surgery, 
      Department of Surgery, University of Louisville, Louisville, KY 40292, USA.
FAU - Jafri, Nadim S
AU  - Jafri NS
FAU - Brangers, Baylor C
AU  - Brangers BC
FAU - Minor, Kyle S
AU  - Minor KS
FAU - Hornung, Carlton A
AU  - Hornung CA
FAU - Galandiuk, Susan
AU  - Galandiuk S
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Surg
JT  - Archives of surgery (Chicago, Ill. : 1960)
JID - 9716528
RN  - 0 (Imino Acids)
RN  - EK22QV7701 (lidofenin)
SB  - IM
MH  - Acalculous Cholecystitis/diagnostic imaging/*surgery
MH  - *Cholecystectomy
MH  - Humans
MH  - Imino Acids
MH  - Radionuclide Imaging
MH  - Treatment Outcome
EDAT- 2009/02/18 09:00
MHDA- 2009/03/13 09:00
CRDT- 2009/02/18 09:00
PHST- 2009/02/18 09:00 [entrez]
PHST- 2009/02/18 09:00 [pubmed]
PHST- 2009/03/13 09:00 [medline]
AID - 144/2/180 [pii]
AID - 10.1001/archsurg.2008.543 [doi]
PST - ppublish
SO  - Arch Surg. 2009 Feb;144(2):180-7. doi: 10.1001/archsurg.2008.543.