Background: Studies have shown that patients with abdominal pain and biliary dyskinesia (low ejection fraction <35 %) have significant improvement of symptoms following laparoscopic cholecystectomy, but there is lack of evidence that demonstrates whether patients with biliary symptoms and a normal ejection fraction (>35 %) will have similar results.
Methods: Retrospective, single center study of patients with biliary pain and negative workup, including HIDA with EF>35 %, who were treated with laparoscopic cholecystectomy from 2017 to 2022.
Results: There were 117 total patients. The mean age was 45.49 ± 15.5 years and 101 (86 %) were female. 101 (86 %) of patients underwent a right upper quadrant ultrasound, 91 had normal findings, 9 difficult to visualize anatomy and 1 had adenomyomatosis. All patients had a normal HIDA scan and ejection fraction 104 (89 %) of patients followed up in clinic within 30 days of surgical intervention. 87 (84 %) reported resolution of pre-operative symptomatology after surgical intervention. There was no statistically significant correlation between pain with CCK administration during HIDA (p = 0.803) scan or ejection fraction (p = 0.0977) with resolution of symptoms.
Conclusions: Laparoscopic cholecystectomy appears to be a beneficial intervention for patients with abdominal pain and normokinetic biliary disease. Offering surgical intervention early on can potentially save patients from exhaustive diagnostic investigations and possibly misdiagnosis.
Keywords: Acalculous biliary pain; Biliary pain; HIDA; Laparoscopic cholecystectomy; functional gallbladder disease.
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