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[PMID]: 28422887 [Au] Autor: Jung SW; Joo MS; Choi HC; Jang SI; Woo YS; Kim JB; Park SH; Lee MS [Ad] Endereço: Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea. [Ti] Título: Epigastric symptoms of gallbladder dyskinesia mistaken for functional dyspepsia: Retrospective observational study. [So] Source: Medicine (Baltimore);96(16):e6702, 2017 Apr. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Functional dyspepsia (FD) is a constellation of epigastric symptoms originating in the gastroduodenal region without organic and metabolic cause. However, similar confounding symptoms can also appear in patients with gallbladder (GB) dyskinesia. Therefore, symptoms of GB dyskinesia may be mistaken for FD. We aimed to identify GB dyskinesia as a cause of FD symptoms compatible with the Rome IV criteria and the need for an evaluation of GB function in patients with FD symptoms.We investigated information of patients with FD symptoms who underwent a quantitative Tc-diisoproyl iminodiacetic acid cholescintigraphy (DISIDA scan) through electronic medical records, and GB dyskinesia was judged to be the cause of the FD symptoms if the symptoms disappeared as GB function normalized on the follow-up DISIA scan in patient with decreased GB function on the initial DISIDA scan.A total of 275 patients underwent a DISIDA scan. Eighteen patients of them had FD symptoms compatible with the Rome IV criteria. Three were lost after undergoing a DISIDA scan. Eight had normal GB function, and the other 7 had decreased GB function on the initial DISIDA scan. In 4 of the 7 patients with GB dyskinesia, FD symptoms disappeared as GB function normalized. As a result, GB dyskinesia was the cause of the symptoms in 4 of 18 patients with FD symptoms compatible with the Rome IV criteria.It is necessary to evaluate GB function in patients with refractory FD symptoms because the symptoms can be caused by GB dyskinesia. [Mh] Termos MeSH primário: Discinesia Biliar/diagnóstico [Mh] Termos MeSH secundário: Adulto Discinesia Biliar/diagnóstico por imagem Diagnóstico Diferencial Dispepsia/diagnóstico Feminino Seres Humanos Masculino Meia-Idade Cintilografia Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170509 [Lr] Data última revisão: 170509 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170420 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000006702

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[PMID]: 28381385 [Au] Autor: Goussous N; Maqsood H; Spiegler E; Kowdley GC; Cunningham SC [Ad] Endereço: Department of Surgery, Saint Agnes Hospital, Baltimore, USA. Steven.Cunningham@stagnes.org. [Ti] Título: HIDA scan for functional gallbladder disorder: ensure that you know how the scan was done. [So] Source: Hepatobiliary Pancreat Dis Int;16(2):197-201, 2017 Apr. [Is] ISSN: 1499-3872 [Cp] País de publicação: Singapore [La] Idioma: eng [Ab] Resumo: BACKGROUND: Despite the increasing use of fatty meal (FM) as a substitute for cholecystokinin (CCK) in pain reproduction during hepato-imino-diacetic acid (HIDA) scan in functional gallbladder disorder, there are no studies comparing the differences between CCK and FM. The present study was to compare the efficacy of FM in comparison of CCK in FGBD application. METHODS: Patients undergoing HIDA scans from August 2013 to May 2014 were divided into two groups: those undergoing CCK-stimulated HIDA scan versus FM-stimulated HIDA scan. These groups were compared according to demographics and HIDA results. RESULTS: Of 153 patients, 70 received CCK and 83 FM. There was no difference regarding age, gender, gallstones, gallbladder ejection fraction and time to visualization. However, significantly more of the patients receiving CCK than FM experienced pain reproduction (61% vs 30%, P<0.01). CONCLUSIONS: Stimulation of gallbladder contractility with a FM during HIDA is less than half as likely to reproduce biliary symptoms compared to CCK, despite similar ejection fractions and other parameters. It is essential that providers account for this difference when counseling patients regarding cholecystectomy for functional gallbladder disorder. [Mh] Termos MeSH primário: Discinesia Biliar/diagnóstico por imagem Vesícula Biliar/diagnóstico por imagem Iminoácidos/administração & dosagem Compostos Radiofarmacêuticos/administração & dosagem [Mh] Termos MeSH secundário: Dor Abdominal/etiologia Adolescente Adulto Idoso Idoso de 80 Anos ou mais Discinesia Biliar/fisiopatologia Discinesia Biliar/cirurgia Colecistectomia Colecistocinina/administração & dosagem Colecistocinina/efeitos adversos Gorduras na Dieta/administração & dosagem Gorduras na Dieta/efeitos adversos Feminino Vesícula Biliar/fisiopatologia Vesícula Biliar/cirurgia Seres Humanos Masculino Meia-Idade Valor Preditivo dos Testes Vitamina K/administração & dosagem Vitamina K/efeitos adversos Adulto Jovem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Dietary Fats); 0 (Ensure Plus); 0 (Imino Acids); 0 (Radiopharmaceuticals); 12001-79-5 (Vitamin K); 9011-97-6 (Cholecystokinin); EK22QV7701 (lidofenin) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171023 [Lr] Data última revisão: 171023 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170407 [St] Status: MEDLINE

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[PMID]: 27521713 [Au] Autor: Rothstein DH; Harmon CM [Ad] Endereço: Department of Pediatric Surgery, Women and Children׳s Hospital of Buffalo, 219 Bryant St, Buffalo, New York 14222; Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York. [Ti] Título: Gallbladder disease in children. [So] Source: Semin Pediatr Surg;25(4):225-31, 2016 Aug. [Is] ISSN: 1532-9453 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Biliary disease in children has changed over the past few decades, with a marked rise in incidence-perhaps most related to the parallel rise in pediatric obesity-as well as a rise in cholecystectomy rates. In addition to stone disease (cholelithiasis), acalculous causes of gallbladder pain such as biliary dyskinesia, also appear to be on the rise and present diagnostic and treatment conundrums to surgeons. [Mh] Termos MeSH primário: Doenças da Vesícula Biliar [Mh] Termos MeSH secundário: Discinesia Biliar/diagnóstico Discinesia Biliar/cirurgia Criança Colecistectomia/métodos Diagnóstico Diferencial Doenças da Vesícula Biliar/diagnóstico Doenças da Vesícula Biliar/etiologia Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170317 [Lr] Data última revisão: 170317 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160814 [St] Status: MEDLINE

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[PMID]: 27049778 [Au] Autor: Richmond BK; Grodman C; Walker J; Dean S; Tiley EH; Hamrick RE; Statler K; Emmett M [Ad] Endereço: Department of Surgery, West Virginia University/Charleston Division, Charleston, WV. Electronic address: brichmond@hsc.wvu.edu. [Ti] Título: Pilot Randomized Controlled Trial of Laparoscopic Cholecystectomy vs Active Nonoperative Therapy for the Treatment of Biliary Dyskinesia. [So] Source: J Am Coll Surg;222(6):1156-63, 2016 Jun. [Is] ISSN: 1879-1190 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Despite widespread adoption by the surgical community, high-quality prospective data supporting the practice of laparoscopic cholecystectomy (LC) for the treatment of biliary dyskinesia (BD) are lacking. STUDY DESIGN: Adult patients meeting criteria for diagnosis of BD (Rome III symptoms, normal ultrasound, gallbladder ejection fraction < 38%) were randomized to either LC or a trial of nonoperative (NO) therapy with a low-dose neuromodulator (amitriptyline 25 mg/day). Patients in the NO arm were allowed to cross over to the surgical arm and remain in the study for any reason. Besides collection of basic demographics and medical/surgical history, patients were administered a standardized quality of life (QOL) assessment (Short Form-8) and a symptom-specific questionnaire (Rome III criteria) at enrollment and monthly through the study to assess the effect of treatment on biliary symptoms and overall QOL. RESULTS: Thirty patients were enrolled over 12 months (15 LC, 15 NO). In the LC group, 13 underwent LC, 1 refused surgery, 1 withdrew. In the NO group, 14 crossed over to the LC group (13 of whom had LC), yielding 26 patients who underwent LC. The SF-8 physical scores (PCS-8) were significantly improved at both the first and last follow-up visits (p < 0.0001, p = 0.0003, respectively). The SF-8 mental scores (MCS-8) were also significantly improved at both the first and last follow-up visits (p = 0.0187, p = 0.0017, respectively). With median follow-up of 12 months (range 3 to 14 months), all 26 reported relief of pain. CONCLUSIONS: This pilot study raises doubts regarding the feasibility of a randomized trial, presumably due to both clinician and patient bias toward LC and the lack of "gold-standard" nonoperative treatments. However, these prospective data indicate that, with careful patient selection (standardized symptom criteria/imaging methodology), LC results in pain relief and significant improvement in QOL in BD patients. Further prospective study of these findings is warranted. [Mh] Termos MeSH primário: Inibidores da Captação Adrenérgica/uso terapêutico Amitriptilina/uso terapêutico Discinesia Biliar/terapia Colecistectomia Laparoscópica [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Esquema de Medicação Estudos de Viabilidade Feminino Seguimentos Seres Humanos Masculino Meia-Idade Projetos Piloto Estudos Prospectivos Qualidade de Vida Resultado do Tratamento Adulto Jovem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Adrenergic Uptake Inhibitors); 1806D8D52K (Amitriptyline) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170721 [Lr] Data última revisão: 170721 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 160407 [St] Status: MEDLINE

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[PMID]: 26932549 [Au] Autor: Escobar-Dominguez JE; Garcia-Quintero P; Hernandez-Murcia C; Verdeja JC [Ad] Endereço: Baptist Health Medical Group - General Surgery, Baptist Health South Florida, Miami, FL, USA. [Ti] Título: Outcomes in laparoscopic cholecystectomy by single incision with SPIDER surgical system are comparable to conventional multiport technique: one surgeon's experience. [So] Source: Surg Endosc;30(11):4793-4799, 2016 Nov. [Is] ISSN: 1432-2218 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: BACKGROUND: Single-incision laparoscopic cholecystectomy has emerged as an alternative to conventional multiport laparoscopic cholecystectomy (LC). Technical difficulty, prolonged surgical times and increased complication rates have been reported in single-incision laparoscopic surgery. One of the concerns is lack of triangulation of instruments. The SPIDER surgical system is a single-incision laparoscopic device that utilizes flexible instruments with the purpose of achieving adequate triangulation. The purpose of this study is to compare the outcomes of SPIDER versus LC. METHODS: A retrospective chart review of patients who underwent LC and SPIDER cholecystectomy by a single surgeon during a concurrent 44-month period at Baptist Health South Florida hospitals was performed focusing on demographics, indication for surgery, complications and incisional hernia rates. Exclusion criteria were concomitant surgery and hernia repair at the time of surgery. RESULTS: A total of 612 patients underwent minimally invasive cholecystectomy: 279 cases for SPIDER cholecystectomy and 333 for multiport LC. Baseline differences in patient characteristics between the SPIDER and LC groups were statistically significant. The SPIDER group had younger and healthier patients (lower ASA classification scores) with predominant diagnosis of cholelithiasis (69 %) compared to the LC group which had more complex cases. Total complications rate for both SPIDER and LC were 0.4 % (n = 1) and 3 % (n = 10), respectively. Conversion to open cholecystectomy occurred in one patient from the LC group (0.3 %). Conversion rate from SPIDER to additional ports or LC was performed in 5 cases (1.8 %) with no conversions to open surgery. Hemoperitoneum was reported in 2 cases, one for each approach, requiring reoperation. CONCLUSION: Single-incision laparoscopic cholecystectomy with SPIDER is a safe and feasible technique with similar outcomes to multiport LC. However, statistical significant difference was reported in baseline characteristics of both groups. No incisional hernias were reported in this case series for either technique. [Mh] Termos MeSH primário: Colecistectomia Laparoscópica/métodos Colecistite/cirurgia Colelitíase/cirurgia [Mh] Termos MeSH secundário: Adulto Idoso Animais Discinesia Biliar/cirurgia Estudos de Casos e Controles Colecistectomia Laparoscópica/instrumentação Conversão para Cirurgia Aberta Feminino Florida Hemoperitônio/epidemiologia Seres Humanos Laparoscopia Masculino Meia-Idade Duração da Cirurgia Pancreatite/cirurgia Complicações Pós-Operatórias/epidemiologia Reoperação Estudos Retrospectivos Cirurgiões [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 171010 [Lr] Data última revisão: 171010 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160303 [St] Status: MEDLINE

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[PMID]: 26409755 [Au] Autor: Dairi S; Demeusy A; Sill AM; Patel ST; Kowdley GC; Cunningham SC [Ad] Endereço: Department of Surgery, Saint Agnes Hospital, Baltimore, Maryland. [Ti] Título: Implications of gallbladder cholesterolosis and cholesterol polyps? [So] Source: J Surg Res;200(2):467-72, 2016 Feb. [Is] ISSN: 1095-8673 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The clinical significance of cholesterolosis has not been well established but there are some provocative, if not robust, studies of the role it may play in the pathophysiology of pancreatitis and biliary dyskinesia, as well as hypercholesterolemia. Our aim was to take advantage of a very large cholecystectomy (CCY) database to support or refute these potentially important reported associations. MATERIALS AND METHODS: A retrospective review of 6868 patients who underwent CCY from 2001-2013 was performed. Comparisons were made using the student t-test for continuous and chi-square analysis for categorical, variables. RESULTS: Among patients for whom the CCY was the primary operation, 1053 (18%) had cholesterolosis and 4596 did not. Compared to those without cholesterolosis, those with cholesterolosis were no more likely to have elevated cholesterol levels (P = 0.64) nor low gallbladder ejection fraction (P = 0.2). To evaluate cholesterolosis as a cause of pancreatitis, all patients with gallstones were eliminated, leaving 639 patients. Among these, not only was cholesterolosis not associated with more pancreatitis, but rather there was not a single patient with or without cholesterolosis who had pancreatitis. CONCLUSIONS: Despite prior reports of associations between cholesterolosis and elevated serum cholesterol, depressed ejection fraction, and increased risk of pancreatitis, careful analysis of this current, larger data set does not support these associations. Any patient with stones or sludge, or with biliary dyskinesia, and appropriate symptoms, should be considered for CCY, with or without suspected cholesterolosis. [Mh] Termos MeSH primário: Discinesia Biliar/etiologia Colecistectomia Colesterol/metabolismo Doenças da Vesícula Biliar/complicações Hipercolesterolemia/etiologia Pancreatite/etiologia Pólipos/complicações [Mh] Termos MeSH secundário: Adulto Idoso Biomarcadores/metabolismo Bases de Dados Factuais Feminino Doenças da Vesícula Biliar/metabolismo Seres Humanos Masculino Meia-Idade Pólipos/metabolismo Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Biomarkers); 97C5T2UQ7J (Cholesterol) [Em] Mês de entrada: 1605 [Cu] Atualização por classe: 151225 [Lr] Data última revisão: 151225 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 150928 [St] Status: MEDLINE

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[PMID]: 27249869 [Au] Autor: Polunina TE [Ti] Título: [DYSFUNCTION OF THE BILIARY TRACT: DIAGNOSIS AND TREATMENT]. [So] Source: Eksp Klin Gastroenterol;(10):65-72, 2015. [Is] ISSN: 1682-8658 [Cp] País de publicação: Russia (Federation) [La] Idioma: rus [Mh] Termos MeSH primário: Discinesia Biliar/diagnóstico Discinesia Biliar/tratamento farmacológico Sistema Biliar/fisiopatologia [Mh] Termos MeSH secundário: Algoritmos Discinesia Biliar/fisiopatologia Sistema Biliar/efeitos dos fármacos Diagnóstico Diferencial Seres Humanos Disfunção do Esfíncter da Ampola Hepatopancreática/diagnóstico Disfunção do Esfíncter da Ampola Hepatopancreática/tratamento farmacológico Disfunção do Esfíncter da Ampola Hepatopancreática/fisiopatologia [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1606 [Cu] Atualização por classe: 160602 [Lr] Data última revisão: 160602 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160603 [St] Status: MEDLINE

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[PMID]: 26140885 [Au] Autor: Eckenrode AH; Ewing JA; Kotrady J; Hale AL; Smith DE [Ad] Endereço: Greenville Health System, Greenville, South Carolina, USA. [Ti] Título: HIDA Scan with Ejection Fraction Is over Utilized in the Management of Biliary Dyskinesia. [So] Source: Am Surg;81(7):669-73, 2015 Jul. [Is] ISSN: 1555-9823 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Patients with upper abdominal pain, nausea, and vomiting are often evaluated with ultrasound to diagnose symptomatic cholelithiasis or cholecystitis. With a normal ultrasound, a hepatobiliary iminodiacetic acid (HIDA) scan with ejection fraction (EF) is recommended to evaluate gallbladder function. The purpose of this study was to evaluate whether the HIDA scan with EF was appropriately utilized in considering cholecystectomy. Over 18 months, we performed 1533 HIDA scans with EF. After exclusion, 1501 were analyzable, 438 of whom underwent laparoscopic cholecystectomy. Patients were divided into two groups: those with typical and atypical symptoms of biliary colic. Our primary endpoint was symptom resolution of those who underwent laparoscopic cholecystectomy. Symptom resolution was assessed by chart review of postop visits or readmissions. In patients with typical symptoms, resolution occurred in 66 per cent of patients with positive HIDA and 77 per cent with negative HIDA (P = 0.292). In patients with atypical symptoms, resolution occurred in 64 per cent of patients with positive HIDA and 43 per cent with negative HIDA (P = 0.013). A HIDA scan with EF was not useful in patients with typical symptoms of biliary colic and negative ultrasounds, and should not be used to make a decision for cholecystectomy. However, this test can be helpful in patients with atypical symptoms, as it does predict symptom improvement in this group. [Mh] Termos MeSH primário: Discinesia Biliar/diagnóstico por imagem Técnicas de Diagnóstico do Sistema Digestório/utilização Iminoácidos Compostos Radiofarmacêuticos Disofenina Tecnécio Tc 99m [Mh] Termos MeSH secundário: Adulto Colecistectomia Laparoscópica Feminino Seres Humanos Masculino Meia-Idade Valor Preditivo dos Testes Cintilografia Estudos Retrospectivos Ultrassonografia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Imino Acids); 0 (Radiopharmaceuticals); EK22QV7701 (lidofenin); QTJ2VIW97T (Technetium Tc 99m Disofenin) [Em] Mês de entrada: 1509 [Cu] Atualização por classe: 161125 [Lr] Data última revisão: 161125 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 150705 [St] Status: MEDLINE

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[PMID]: 26116320 [Au] Autor: Thiels CA; Cima RR; Habermann EB [Ad] Endereço: Department of Surgery, Mayo Clinic, Rochester, MN, USA. [Ti] Título: In response to: Preston JF, Diggs BS, Dolan JP, Gilbert EW, Schein M, Hunter JG. Biliary dyskinesia: a surgical disease rarely found outside the United States. Am J Surg. 2015;209:799-803. [So] Source: Am J Surg;210(5):963, 2015 Nov. [Is] ISSN: 1879-1883 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Discinesia Biliar/epidemiologia Sistema de Registros [Mh] Termos MeSH secundário: Feminino Seres Humanos Masculino [Pt] Tipo de publicação: COMMENT; LETTER [Em] Mês de entrada: 1601 [Cu] Atualização por classe: 151017 [Lr] Data última revisão: 151017 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 150628 [St] Status: MEDLINE

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[PMID]: 25891671 [Au] Autor: Mahida JB; Sulkowski JP; Cooper JN; King AP; Deans KJ; King DR; Minneci PC [Ad] Endereço: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, Columbus, Ohio. [Ti] Título: Prediction of symptom improvement in children with biliary dyskinesia. [So] Source: J Surg Res;198(2):393-9, 2015 Oct. [Is] ISSN: 1095-8673 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Rates of cholecystectomy for biliary dyskinesia are rising. Our objective was to identify clinical determinants of symptom improvement in children undergoing cholecystectomy for biliary dyskinesia. METHODS: This retrospective cohort study included patients undergoing cholecystectomy for biliary dyskinesia from 2006-2013 who had their gallbladder ejection fraction (EF) measured by either cholecystokinin-stimulated hepatobiliary iminodiacetic acid scan and/or fatty meal ultrasound. Patients presenting from 2010-2013 were interviewed >1 y after cholecystectomy to determine symptom improvement, complete symptom resolution, and any postoperative clinical interventions related to biliary dyskinesia. Sensitivity and positive predictive values for the diagnostic tests for symptom improvement were calculated. Multivariable logistic regression models were used to identify preoperative characteristics associated with symptom improvement. RESULTS: Of the 153 included patients, 76% were female, 89% were Caucasian, and 39% were obese. At postoperative evaluation, symptom improvement was reported by 82% of the patients and complete symptom resolution in 56%. For both the hepatobiliary iminodiacetic acid and fatty meal ultrasound, the sensitivity of the test to predict symptom improvement increased with higher EF, whereas the positive predictive values remained around 80%. Of the 41 patients who participated in phone interview for long-term follow-up, 85% reported symptom improvement and 44% reported complete symptom resolution. Factors associated with symptom improvement included a shorter duration of pain, a history of vomiting, and a history of epigastric pain. CONCLUSIONS: Despite not identifying an EF level that predicted symptom improvement, over 80% of patients undergoing cholecystectomy for biliary dyskinesia reported symptom improvement. These results support continuing to offer cholecystectomy to treat biliary dyskinesia in children. [Mh] Termos MeSH primário: Discinesia Biliar/diagnóstico Colecistectomia Esvaziamento da Vesícula Biliar Vesícula Biliar/diagnóstico por imagem [Mh] Termos MeSH secundário: Adolescente Discinesia Biliar/fisiopatologia Discinesia Biliar/cirurgia Criança Técnicas de Diagnóstico do Sistema Digestório Feminino Seres Humanos Ohio/epidemiologia Dor Pós-Operatória/epidemiologia Valor Preditivo dos Testes Cintilografia Estudos Retrospectivos Resultado do Tratamento Ultrassonografia [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1511 [Cu] Atualização por classe: 161125 [Lr] Data última revisão: 161125 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 150421 [St] Status: MEDLINE

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