PMID- 33284026
OWN - NLM
STAT- MEDLINE
DCOM- 20210906
LR  - 20210906
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 87
IP  - 6
DP  - 2021 Jun
TI  - Optimal Management of the Hyperkinetic Gallbladder: A Comparison of Outcomes 
      Between Operative and Nonoperative Approaches.
PG  - 903-909
LID - 10.1177/0003134820966283 [doi]
AB  - BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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. DISCUSSION: 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.
FAU - Williford, Michael L
AU  - Williford ML
AD  - Department of Surgery, 1371Emory University, Atlanta, GA, USA.
FAU - Fay, Katherine T
AU  - Fay KT
AD  - Department of Surgery, 1371Emory University, Atlanta, GA, USA.
FAU - Simpson, Francis J
AU  - Simpson FJ
AD  - Department of Surgery, 1371Emory University, Atlanta, GA, USA.
FAU - Defnet, Ann M
AU  - Defnet AM
AD  - Department of Surgery, 1371Emory University, Atlanta, GA, USA.
FAU - Schuster, David M
AU  - Schuster DM
AD  - Department of Radiology, 1371Emory University, Atlanta, GA, USA.
FAU - Sethi, Ila
AU  - Sethi I
AD  - Department of Radiology, 1371Emory University, Atlanta, GA, USA.
FAU - Lin, Edward
AU  - Lin E
AD  - Department of Surgery, 1371Emory University, Atlanta, GA, USA.
FAU - Davis, Steven Scott Jr
AU  - Davis SS Jr
AD  - Department of Surgery, 1371Emory University, Atlanta, GA, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20201207
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - Adult
MH  - Biliary Dyskinesia/diagnostic imaging/*therapy
MH  - *Cholecystectomy
MH  - *Conservative Treatment
MH  - Female
MH  - Georgia
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Surveys and Questionnaires
EDAT- 2020/12/08 06:00
MHDA- 2021/09/07 06:00
CRDT- 2020/12/07 12:08
PHST- 2020/12/08 06:00 [pubmed]
PHST- 2021/09/07 06:00 [medline]
PHST- 2020/12/07 12:08 [entrez]
AID - 10.1177/0003134820966283 [doi]
PST - ppublish
SO  - Am Surg. 2021 Jun;87(6):903-909. doi: 10.1177/0003134820966283. Epub 2020 Dec 7.