Hypokinetic gallbladder disease: A cause of chronic abdominal pain in children and adolescents

Background/Purpose: Impaired gallbladder emptying has been identified as a cause of chronic abdominal pain in adults. This study aims to define a pedi atric population with functional abnormalities of gallbladder contractility and to assess clinical outcome after cholecystectomy. Methods: Children and adolescents (n = 42) with abdominal complaints underw ent gallbladder emptying studies, measured by either ultrasonography or sci ntigraphy with intravenous cholecystokinin (CCK). On ultrasound studies, ga llbladder volume was measured before injection and 15 minutes after injecti on. Measures of gallbladder emptying by scintigraphy were taken at least 30 minutes after CCK injection. A study was classified as abnormal for contra ctility less than 50%. Cholecystectomy was performed and outcomes were eval uated during office visits and by telephone interview. Results: Abdominal pain and fatty food intolerance were the predominant sym ptoms. Patients we re treated by open (n = 2) or laparoscopic (n = 40) chol ecystectomy. In 20 cases the gallbladder showed chronic inflammation on pat hology. Response to surgical therapy was excellent in 41 patients (mean fol low-up, 20.4 months). Conclusions: Children and adolescents with persistent abdominal pain should undergo functional assessment of gallbladder contractility. Patients with abnormal gallbladder contractility benefit from cholecystectomy. Copyright (C) 1999 by W.B. Saunders Company.