Association of gallbladder hyperkinesia with acalculous chronic cholecystitis: A case-control study

Ravishankar Pillenahalli Maheshwarappa; Yusuf Menda; Michael M Graham; Sarag A Boukhar; Gideon K.D Zamba; Isaac Samuel

doi:10.1016/j.surg.2020.06.005

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Association of gallbladder hyperkinesia with acalculous chronic cholecystitis: A case-control study

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Association of gallbladder hyperkinesia with acalculous chronic cholecystitis: A case-control study

Ravishankar Pillenahalli Maheshwarappa, Yusuf Menda, Michael M Graham, Sarag A Boukhar, Gideon K.D Zamba and Isaac Samuel

Surgery, Vol.168(5), pp.800-808

11/2020

DOI: 10.1016/j.surg.2020.06.005

PMID: 32653205

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Abstract

This is the first case-control study investigating an association between gallbladder hyperkinesia and symptomatic acalculous chronic cholecystitis. This retrospective study in a single academic center compared resolution of biliary pain in adults with gallbladder hyperkinesia, defined as a hepatobiliary iminodiacetic acid scan ejection fraction ≥80%, undergoing cholecystectomy (study group) with those treated medically without cholecystectomy (control group). Of 1,477 hepatobiliary iminodiacetic acid scans done between 2013 and 2018, a total of 296 adults without gallstones had an ejection fraction ≥80%, of whom 46 patients met predetermined eligibility criteria. Demographic data, hepatobiliary iminodiacetic acid scan ejection fraction, chronicity of pain, and resolution of pain were compared between groups. Demographics (mean ± standard deviation) in the control group (n = 25) and in the study group (n = 21) were, respectively, age 40 y ± 16 y and 39 y ± 14 y, body mass index 28.9 ± 5.2 and 29.1 ± 7.1 kg/m2, with 15 (60%) and 18 (86%) females in each. Resolution of pain after cholecystectomy occurred in 18 of 21 patients (86%); however, pain persisted in 20 of 25 patients (80%) treated medically after mean follow-up of 36 ± 28 months (range 10–120 months) (P < .01). Pain resolution with cholecystectomy was independent of demographic variables, hepatobiliary iminodiacetic acid scan ejection fraction, and chronicity of pain. The odds of pain resolution was 19.7 times greater with cholecystectomy than without (odds ratio, 19.7; 95% confidence interval, 4.34, 89.43; P < .01), and remained robust even with the odds adjusted for each covariate. Gallbladder histopathology confirmed chronic cholecystitis in all 21 cholecystectomy specimens. Symptomatic gallbladder hyperkinesia could be a new indication for cholecystectomy in adults.

Details

Title: Subtitle: Association of gallbladder hyperkinesia with acalculous chronic cholecystitis: A case-control study
Creators: Ravishankar Pillenahalli Maheshwarappa - Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
Yusuf Menda - Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
Michael M Graham - Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
Sarag A Boukhar - Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
Gideon K.D Zamba - Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA
Isaac Samuel - Department of Surgery, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
Resource Type: Journal article
Publication Details: Surgery, Vol.168(5), pp.800-808
DOI: 10.1016/j.surg.2020.06.005
PMID: 32653205
NLM abbreviation: Surgery
ISSN: 0039-6060
eISSN: 1532-7361
Publisher: Elsevier Inc
Language: English
Date published: 11/2020
Academic Unit: Radiology; Pathology; Biostatistics; Surgery; Radiation Oncology
Record Identifier: 9984214677802771

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