Children with laparoscopic cholecystectomy (LC) for suspected BD between 8/2006 and 5/2011 were included. A pathologic ejection fraction (EF) was defined as < 35 % . The long-term effect of cholecystectomy was assessed via a Likert scale symptom questionnaire.
82 children (median age 13.5 years, mean BMI 25.8) were included. CCK-HIDA scan was pathologic in 74 children (90.2 % ). Mean EF was 16.4 % . Histology revealed chronic cholecystitis in 48 (58.5 % ) children and was normal in 30 children (36.5 % ). The frequency of LC for suspected BD increased by a factor of 4.3 in the last 10 years. Long term follow-up showed that only 23/52 children (44.2 % ) were symptom-free after LC. Patients with chronic inflammation were more likely to have persistent symptoms (p = 0.017). An EF < 15 % was associated with a resolution of symptoms (p = 0.031).
The frequency of LC for suspected BD in our institution has increased significantly during recent years. The long-term efficacy in our cohort was only 44.2 % . We believe that laparoscopic cholecystectomy is likely helpful in patients with an EF < 15 % . However, in children with an EF of 15 % -35 % , based upon our data, we would highly recommend an appropriately thorough pre-op testing to exclude other gastrointestinal disorders prior to consideration of operative management.