Ejection fraction of normal gall bladder by ultrasonography in patients with biliary colic: Is it a parameter for cholecystectomy?. | ||
| The Egyptian Journal of Surgery | ||
| Volume 43, Issue 4, October 2024, Pages 1597-1602 PDF (304.18 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/EJSUR.2024.304414.1122 | ||
| Authors | ||
| Abdallah B. Abdallah; Samir A. Ammar; Mohamed G. Ameen; Ahmed Yaseen* | ||
| Department of General Surgery, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt | ||
| Abstract | ||
| Background: Functional biliary disorders such as gallbladder dyskinesia (GBD), biliary hyperkinesia, and sphincter of Oddi dysfunction are common causes of abdominal pain. Although hepatobiliary scintigraphy is the gold standard for diagnosing sphincter of Oddi dysfunction, there is still debate about the best way to establish diagnoses of GBD and whether gallbladder ejection fraction (GBEF) is a reliable predictor of treatment outcomes. Aim: The purpose of this study is to evaluate GBEF as a predictor of GBD and an indicator of cholecystectomy. Patients and Methods: This is a prospective study conducted between July 2021 and December 2023 on patients presented with biliary dyskinesia. All patients with an ejection fraction of less than 35% underwent laparoscopic cholecystectomy. The preoperative workup involved clinical assessment, laboratory tests, fasting and postprandial ultrasounds, and hepatobiliary scintigraphy to determine ejection fraction. Postoperative follow-up at 1, 3, and 6 months assessed pain relief, symptom improvement, and patient satisfaction. Results: Eight patients were excluded due to a GBEF greater than 35%. The remaining 21 patients with an ejection fraction of less than 35% underwent laparoscopic cholecystectomy. The mean age was 31±12 years, and the majority of patients (86%) were females. The preoperative visual analog scale pain score was 7.2±1.4, decreasing significantly to 1.2±0.8 at 1-month follow-up (P<0.001). The pain was fully resolved in all patients by 3 months. Medication usage, daily activity levels, and patient satisfaction also significantly improved. The mean ejection fraction was 27.1±3.3%. No postoperative complications occurred. Conclusion: In patients with GBD, laparoscopic cholecystectomy provided excellent symptomatic relief when GBEF was less than 35%. The ejection fraction appears to be a useful diagnostic predictor of positive surgical outcomes in such functional biliary pain presentations. Larger, controlled clinical trials are needed to generalize the findings. | ||
| Keywords | ||
| Cholecystectomy; functional biliary colic; gallbladder dyskinesia; gallbladder ejection fraction | ||
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