• Biliary dyskinesia in сhildren
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Biliary dyskinesia in сhildren

Modern Pediatrics. Ukraine. (2025).3(147): 97-101. doi: 10.15574/SP.2025.3(147).97101
Bobrova V. I., Bobrov B. G.
Bogomolets National Medical University, Kyiv, Ukraine

For citation: Bobrova VI, Bobrov BG. (2025). Biliary dyskinesia in сhildren. Modern Pediatrics. Ukraine. 3(147): 97-101. doi: 10.15574/SP.2025.3(147).97101.
Article received: Feb 11, 2025. Accepted for publication: Apr 08, 2025.

Biliary dyskinesia in children is a rather controversial diagnosis in the pediatric population, as there are no standardized pediatric diagnostic criteria and treatment.
Аim – to summarize data from the literature regarding risk factors, clinical manifestations, diagnosis, and treatment of biliary dyskinesia in children.
This article presents an overview of current diagnostic strategies and treatment outcomes using both surgical and non-surgical approaches. The only diagnostic method for biliary dyskinesia in both adults and children is cholecystokinin-stimulated cholecyntygraphy. At the same time, there is no standard, validated method for assessing gallbladder motility in children. Despite the lack of high-quality evidence supporting this practice, cholecystectomy remains a commonly used treatment method. The outcomes regarding the prognostic value of medical treatment have been evaluated in studies with small sample sizes, and none of them has been accepted as the "gold standard" of therapy.
Conclusions. The diagnosis and treatment of biliary dyskinesia are challenging due to the combination of vague and diverse symptoms and the absence of definitive, unified diagnostic criteria in the pediatric population.
The authors declare no conflict of interest.
Keywords: children, biliary dyskinesia, cholecystectomy.
REFERENCES

1. Barrett KE, Barman SM, Yuan J, Brooks HL. (2019). Ganong's Review of Medical Physiology. Twenty Sixth Edition 26th Edition. McGraw Hill / LANGE: 752.

2. Cairo SB, Aranda A, Bartz-Kurycki M et al. (2019) Variability in perioperative evaluation and resource utilization in pediatric patients with suspected biliary dyskinesia: a multi-institutional retrospective cohort study. J Pediatr Surg. 54: 1118-1122. https://doi.org/10.1016/j.jpedsurg.2019.02.049; PMid:30885555 PMCid:PMC6822378

3. Cairo SB, Ventro G, Sandoval E, Rothstein DH. (2018). Long-term results of cholecystectomy for biliary dyskinesia: outcomes and resource utilization. J Surg Res. 230: 40-46. https://doi.org/10.1016/j.jss.2018.04.044; PMid:30100038

4. Clark CJ. (2019). An update on biliary dyskinesia. Surg Clin. 99(2): 203-214. https://doi.org/10.1016/j.suc.2018.11.004; PMid:30846030

5. Coluccio M, Claffey AJ, Rothstein DH. (2020). Biliary dyskinesia: fact or fiction? Semin Pediatr Surg. 29: 150947. https://doi.org/10.1016/j.sempedsurg.2020.150947; PMid:32861451

6. De Bruijn CM, Rexwinkel R, Gordon M, Sinopoulou V, Benninga MA, Tabbers MM. (2022, Apr). Dietary interventions for functional abdominal pain disorders in children: a systematic review and meta-analysis. Expert Rev Gastroenterol Hepatol. 16(4): 359-371. Epub 2022 Mar 27. https://doi.org/10.1080/17474124.2022.2055547; PMid:35311425

7. Dekonenko C, Sujka JA, Dorman RM, Oyetunji TA, St. Peter SD. (2020) Self-reported outcomes after cholecystectomy for pediatric hyperkinetic biliary dyskinesia. J Surg Res. 246: 73-77. https://doi.org/10.1016/j.jss.2019.06.088; PMid:31562988

8. Diez S, Müller H, Weiss C et al. (2021). Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons? BMC Gastroenterol. 21(1): 186. https://doi.org/10.1186/s12876-021-01772-y; PMid:33882844 PMCid:PMC8061037

9. Jacobson JC, Bosley ME, Gaffley MW et al. (2022). Pediatric Normokinetic Biliary Dyskinesia: Pain with Cholecystokinin on Hepatobiliary Iminodiacetic Acid Scan Predictive of Symptom Resolution After Cholecystectomy. J Laparoendosc Adv Surg Tech A. 32(7): 794-799. https://doi.org/10.1089/lap.2021.0349; PMid:35404140

10. Klein S, Quartucio E, Miskin B. (2023, Oct 18). Hypokinetic Biliary Dyskinesia in a Pediatric Patient: A Case Report. Cureus. 15(10): e47254. https://doi.org/10.7759/cureus.47254

11. Krishna YT, Griffin KL, Gates RL. (2018) Pediatric biliary dyskinesia: evaluating predictive factors for successful treatment of biliary dyskinesia with laparoscopic cholecystectomy. Am Surg. 84:1401-5. https://doi.org/10.1177/000313481808400939; PMid:30268165

12. Kulaylat AN, Lucas DJ, Chang HL, Derderian SC, Beres AL et al. (2024) Evaluation and Management of Biliary Dyskinesia in Children and Adolescents: A Systematic Review From the APSA Outcomes and Evidence-Based Committee. J Pediatr Surg. 59(11): 161678. https://doi.org/10.1016/j.jpedsurg.2024.08.018; PMid:39227244

13. Kwatra NS, Nurko S, Stamoulis C, Falone AE, Grant FD, Treves ST. (2019) Chronic acalculous cholecystitis in children with biliary symptoms: Usefulness of hepatocholescintigraphy. J Pediatr Gastroentrol Nutr. 68: 68-73. https://doi.org/10.1097/MPG.0000000000002151; PMid:30256266

14. Lai SW, Rothenberg SS, Kay SM, Shipman KE, Slater BJ. (2017, Aug). Outcomes of Laparoscopic Cholecystectomy for Biliary Dyskinesia in Children. J Laparoendosc Adv Surg Tech A. 27(8): 845-850. Epub 2017 Mar 28. https://doi.org/10.1089/lap.2016.0338; PMid:28350202

15. Liebe HL, Phillips R, Handley M, Gastanaduy M, Burton JH, Roybal J. (2021). A pediatric surgeon's dilemma: does cholecystectomy improve symptoms of biliary dyskinesia? Pediatr Surg Int. 37: 1251-1257. https://doi.org/10.1007/s00383-021-04922-1; PMid:33977350

16. Mahida JB, Sulkowski JP, Cooper JN et al.(2015). Prediction of symptom improvement in children with biliary dyskinesia. J Surg Res. 198(2): 393-399. https://doi.org/10.1016/j.jss.2015.03.056; PMid:25891671

17. Matta SR, Kovacic K, Yan K, Simpson P, Sood MR. (2018) Trends of cholecystectomies for presumed biliary dyskinesia in children in the United States. J Pediatr Gastroenterol Nutr. 66: 808-10. https://doi.org/10.1097/MPG.0000000000001777; PMid:29036007

18. Nasri B, Glass T, Singh K, Saxe J. Biliary hyperkinesia: an indication for cholecystectomy? Surg Endosc. 2021 Jul;35(7):3244-3248. Epub 2020 Jul 6. https://doi.org/10.1007/s00464-020-07757-4; PMid:32632487

19. Popover JL, Oulton ZW, Brown ZG. (2025). Biliary Dyskinesia – Is It Real? JSLS. 29(1). https://doi.org/10.4293/JSLS.2024.00053; PMid:40182835 PMCid:PMC11967721

20. Presti ME, Elwing JE, Sayuk GS. (2022) Gallbladder dyskinesia. South Med J. 115: 838-841. https://doi.org/10.14423/SMJ.0000000000001466; PMid:36318951

21. Richmond BK. (2024) Biliary Dyskinesia-Controversies, Diagnosis, and Management: A Review. JAMA Surg. 1; 159(9): 1079-1084. https://doi.org/10.1001/jamasurg.2024.0818; PMid:38959007

22. Richmond BK, Walker A. (2021). Biliary Dyskinesia: Current Perspectives and Future Directions. Am Surg. 87(6): 954-960. https://doi.org/10.1177/0003134820971617; PMid:33295186

23. Rose JB, Fields RC, Strasberg SM. (2018, Feb). Poor Reproducibility of Gallbladder Ejection Fraction by Biliary Scintigraphy for Diagnosis of Biliary Dyskinesia. J Am Coll Surg. 226(2): 155-159. Epub 2017 Nov 17. https://doi.org/10.1016/j.jamcollsurg.2017.10.025; PMid:29157795

24. Santucci NR, Hyman PE, Harmon CM, Schiavo JH, Hussain SZ. (2017, Feb). Biliary Dyskinesia in Children: A Systematic Review. J Pediatr Gastroenterol Nutr. 64(2): 186-193. https://doi.org/10.1097/MPG.0000000000001357; PMid:27472474

25. Shaikh NM. (2021). Gall Stones in Pediatric Population. Edited by Qiang Yan and Huaping Shen. dоі: 10.5772/intechopen.99020.

26. Simon DA, Friesen CA, Schurman JV, Colombo JM. (2020). Biliary dyskinesia in children and adolescents: a mini review. Front Pediatr. 8: 122. https://doi.org/10.3389/fped.2020.00122; PMid:32266192 PMCid:PMC7105807

27. Wyllie R, Hyams JS, Kay M. (2016). Pediatric Gastrointestinal and Liver Disease. 5th ed. Philadelphia, PA: Elsevier.

28. Zangiabadian M, Khalili-chelik A, Hosseini A, Mohajerzadeh L, Sarafi M et al. (2021) Pediatric Gallbladder Dysmotility: Not as Rare as Previously Considered; a Case Report and Review of Literature. J. Compr Ped. 12(2). https://doi.org/10.5812/compreped.115259