Biliary dyskinesia is when there is gallbladder dysmotility, which is defined as a gallbladder ejection fraction < 35%. It was first described in the 19th century. In 1981, Gerbail T. Krishnamurthy described a technique for measuring the ejection fraction of the gallbladder.
History
- Symptoms of calculus biliary disease
- Intermittent RUQ pain → biliary colic
- Nausea
Physical Exam
- Murphy’s sign
Labs
- LFTs
- Bilirubin
- Amylase
- Lipase
Imaging
- US
- Findings: no evidence of stones or sludge
- CCK-stimulated HIDA scan
- Findings: EF < ⅓ at 20 minutes after CCK administration in patient without a stone is considered diagnostic
- CT and endoscopy may be used to rule out other diagnoses
Treatment
- Cholecystectomy: > 85% of patients show improvement in symptoms
- ERCP: if nonresponsive to cholecystectomy
Relevant Information
- Normal gallbladder ejection fraction is ≥ 35%
Scoring System
