Variability in perioperative evaluation and resource utilization in pediatric patients with suspected biliary dyskinesia: A multi-institutional retrospective cohort study.
DOI: 10.1016/j.jpedsurg.2019.02.049; PMCID: PMC6822378
INTRODUCTION: Biliary dyskinesia (BD) is a common indication for pediatric cholecystectomy. While diagnosis is primarily based on diminished gallbladder ejection fraction (GB-EF), work-up and management in pediatrics is controversial.
METHODS: We conducted a multi-institutional retrospective review of children undergoing cholecystectomy for BD to compare perioperative work-up and outcomes.
RESULTS: Six hundred seventy-eight patients across 16 institutions were included. There was no significant difference in gender, age, or BMI among institutions. Most patients were white (86.3%), non-Hispanic (79.9%), and had private insurance (55.2%). Gallbladder ejection fraction (EF) was reported in 84.5% of patients, and 44.8% had an EF
CONCLUSION: There is significant variability in evaluation and follow-up both before and after cholecystectomy for BD. Prospective research with standardized data collection and follow-up is needed to develop and validate optimal care pathways for pediatric patients with suspected BD.
STUDY TYPE: Case Series, Retrospective Review.
LEVEL OF EVIDENCE: Level IV.
Journal of pediatric surgery
Biliary Dyskinesia; Cholecystectomy; Perioperative Care; Child; Treatment Outcome
Biliary dyskinesia; Cholecystectomy; Functional gallbladder disorder; Gastroenterology; Pediatric surgery; Gall Bladder Surgery
Cairo, S. B., Aranda, A., Bartz-Kurycki, M., Baxter, K. J., Bonasso, P., Dassinger, M., Deans, K. J., Dorey, D., Emengo, P., Fialkowski, E., Gayer, C., Gonzales, B., Gusman, N., Hawkins, R., Herzing, K., Huang, E., Islam, S., Jancelewicz, T., Landman, M. P., Lally, K. P., Lesher, A., Minneci, P. C., Raval, M. V., Russell, R., Shah, S., Slater, B., Schoel, L. J., St Peter, S. D., Sujka, J., Waterhouse, J., Rothstein, D. H., . Variability in perioperative evaluation and resource utilization in pediatric patients with suspected biliary dyskinesia: A multi-institutional retrospective cohort study. Journal of pediatric surgery 54, 1118-1122 (2019).