Gallbladder Dysfunction: How Much Longer Will It Be Controversial?

Abstract

Background: Motility disorders of the biliary tree [biliary dyskinesia, including both gallbladder dysfunction (GBD), and sphincter of Oddi dysfunction] are difficult to diagnose and to treat. Summary: There is controversy in the literature in particular regarding the criteria that should be used to select patients for cholecystectomy (CCY) in cases of suspected GBD. The current review covers the history, diagnosis, and treatment of GBD. Key Messages: Only >85% of patients with suspected GBD have relief following CCY, a much lower rate than the nearly 100% success rate following CCY for gallstone disease. Unfortunately, the literature is lacking, and there are no universally agreed-upon criteria for selecting which patients to refer for operation, although cholecystokinin (CCK)-enhanced hepatobiliary iminodiacetic acid scan is often used, with emphasis on an abnormally low gallbladder ejection fraction or pain reproduction at CCK administration. There is a clear need for large, well-designed, more definitive, prospective studies to better identify the indications for and efficacy of CCY in cases of GBD. i 2014 S. Karger AG, Basel

The personal oriented educational program in the management of patients with biliary pathology

“…В последние десятилетия отмечена устойчивая тенденция к росту заболеваемости хроническим холециститом. Данная патология встречается не только в зрелом, но и в молодом возрасте [4,5,6,7]. Современный подход к медико-социальной проблеме больных подразумевает комплекс мероприятий, направленных на предупреждение развития осложнений [8,9,10].…”

Ultrasound Image Based Human Gallbladder 3D Modelling along with Volume and Stress Level Assessment

“…A few meta-analyses on the existing outcome after LC based on CCK-cholescintigraphy or ultrasound scans for ABP patients were performed [24][25][26][27], and it was indicated that the use of EF to select patient with suspected ABP is not supported, even though the symptom is more significantly relived than nonoperative therapy; consequently, randomized clinical trials are on demand [24,25,28,29]. To standardize the trials and make the outcomes of different trials comparable, a protocol was recommended based on 0.02 µg/kg sincalide over 60 min with normal EF specified ≥ 38% [30].…”

Constitutive law of healthy gallbladder walls in passive state with damage effect

“…GBs can suffer from a variety of disease such as gallstones, cholecystitis, acalculous gallbladder disease, biliary dyskinesia and gallbladder cancer [2,15,29]. The disease can alter passive and active biomechanical properties of GB wall [1,4,7,12,25]. Thus, the biomechanical properties of GB wall should be valuable to diagnosis of GB diseases.…”