Variability in perioperative evaluation and resource utilization in pediatric patients with suspected biliary dyskinesia: A multi-institutional retrospective cohort study.
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.
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, Sarah B.; Aranda, Arturo; Bartz-Kurycki, Marisa; Baxter, Katherine J.; Bonasso, Patrick; Dassinger, Melvin; Deans, Katherine J.; Dorey, Danielle; Emengo, Pamela; Fialkowski, Elizabeth; Gayer, Christopher; Gonzales, Brandy; Gusman, Nakada; Hawkins, Russell B; Herzing, Karen; Huang, Eunice; Islam, Saleem; Jancelewicz, Timothy; Landman, Matthew P.; Lally, Kevin P.; Lesher, Aaron; Minneci, Peter C.; Raval, Mehul V.; Russell, Robert; Shah, Sohail; Slater, Bethany; Schoel, Leah J.; St Peter, Shawn D.; Sujka, Joseph; Waterhouse, Jennifer; Rothstein, David H.; and Pediatric Surgery Research Collaborative (PedSRC), "Variability in perioperative evaluation and resource utilization in pediatric patients with suspected biliary dyskinesia: A multi-institutional retrospective cohort study." (2019). Manuscripts, Articles, Book Chapters and Other Papers. 543.