How Common is Biliary Dyskinesia?

Symptoms of Biliary Dyskinesia

Causes of Biliary Dyskinesia

The gallbladder is a small, pear-shaped organ present in the upper abdomen on the right side, just below the liver. The liver produces a greenish-brown fluid called bile, which is important in the digestion of food. The normal function of gallbladder is to store and concentrate bile. When you eat a meal, the gallbladder contracts and releases bile in the intestine to help in the digestion of food. However, if you are having biliary dyskinesia, the bile is not released and remains in the gallbladder.

Risk Factors of Biliary Dyskinesia

Biliary dyskinesia are more frequently found in those who:

• Are overweight or obese
• Experience rapid weight changes
• Lack of physical activity
• Have diabetes mellitus
• Suffer from hormonal imbalances

Diagnosis of Biliary Dyskinesia

Your doctor will first take a detailed history and perform the relevant physical examination. Your physical examination will be normal in most cases of biliary dyskinesia. However, if the gallbladder gets inflamed (cholecystitis), then you will feel pain when your doctor touched your upper abdomen with his hand.

Biliary dyskinesia is often diagnosed when gallstones are not found during an exam despite a clinical history suggestive of gallstones. Your doctor may order the following tests:

• Ultrasound of the abdomen
• Computed tomography (CT) scan or magnetic resonance imaging (MRI) of the abdomen

Your doctor may also order additional tests if needed, such as

• Magnetic resonance cholangiopancreatography (MRCP)
• X-ray abdomen
• HIDA (Hepatobiliary Imino-Diacetic Acid) scan: In this test, a small amount of radioactive dye will be given through intravenous route and pictures will be taken. Your doctor will look at the pictures to see if your liver and gallbladder are working normally.

Treatment of Biliary Dyskinesia

If your biliary dyskinesia is not causing you much problems, you should be reassured that no further treatment is necessary. You will be prescribed appropriate pain killers and advised to maintain healthy life style by losing weight, if you are overweight. You should eat fruits, vegetables, and high-fiber diet.

If the biliary dyskinesia is causing symptoms then your doctor may recommend surgery to remove the gallbladder.

• Surgical Management of Biliary Dyskinesia

The main surgical treatment for problematic biliary dyskinesia is to remove the gallbladder. This procedure is called cholecystectomy. It is often performed by a laparoscopic procedure.

• In laparoscopic cholecystectomy surgery, your doctor will make several small, half-inch incisions in the abdominal wall. Your doctor will then insert a laparoscope, which is a thin tube with a tiny video camera attached. Your doctor will then cut the gallbladder and remove it from the body.This procedure is performed on an outpatient basis and you may be discharged on the same day. You may even continue your daily activities after a day or two.5
• In some cases, an open cholecystectomy is required. It is not preferred due to increased hospital stay, pain, and complications. In this procedure, your doctor will give a formal incision in your abdomen wall and will directly visualize the gallbladder and remove it. He will apply the sutures and close your abdominal wall. This procedure takes more time to recovery than a laparoscopic surgery.