Laparoscopic cholecystectomy: Effective treatment for chronic abdominal pain in children with acalculous biliary pain

Background/Purpose:Acalcular biliary pain is a term used to identify patien ts who have significant abdominal pain related to an abnormally low gallbla dder ejection fraction in the absence of cholelithiasis. Little is known ab out this disease in the pediatric population. The aim of this study was to determine whether laparoscopic cholecystectomy is an effective method for t reatment of children with abdominal pain in the setting of acalcular biliar y pain and whether one can predict the outcome preoperatively. Methods: The charts of all children who underwent laparoscopic cholecystect omy for acalcular biliary pain in our institution from January 1991 through April 1998 were reviewed. Sixty-three patients were identified as children with acalcular biliary pain who underwent laparoscopic cholecystectomy. Fo rty-eight patients were contacted successfully and they all completed the q uestionnaire. Complete resolution of abdominal pain occurred in 72%, and an other 18% had near-complete resolution of pain. Some improvement was noted by 8%, and only 2% had no improvement. In a multiple logistic model, none o f the variables were significant predictors of response outcome, Conclusions; Laparoscopic cholecystectomy is an effective means of therapy for children with abdominal pain and low gallbladder ejection fraction. It is difficult to predict patients with complete response based on the preope rative clinical findings. J Pediatr Surg 36:1394-1396. Copyright (C) 2001 b y W.B. Saunders Company.