TY - JOUR
T1 - Evaluation and Management of Biliary Dyskinesia in Children and Adolescents
T2 - A Systematic Review From the APSA Outcomes and Evidence-Based Committee
AU - Kulaylat, Afif N.
AU - Lucas, Donald J.
AU - Chang, Henry L.
AU - Derderian, S. Christopher
AU - Beres, Alana L.
AU - Ham, P. Benson
AU - Huerta, Carlos T.
AU - Sulkowski, Jason P.
AU - Wakeman, Derek
AU - Englum, Brian R.
AU - Gulack, Brian C.
AU - Acker, Shannon N.
AU - Gonzalez, Katherine W.
AU - Levene, Tamar L.
AU - Christison-Lagay, Emily
AU - Mansfield, Sara A.
AU - Yousef, Yasmine
AU - Pennell, Christopher P.
AU - Russell, Katie W.
AU - Rentea, Rebecca M.
AU - Tashiro, Jun
AU - Diesen, Diana L.
AU - Alemayehu, Hanna
AU - Ricca, Robert
AU - Kelley-Quon, Lorraine
AU - Rialon, Kristy L.
N1 - Publisher Copyright:
© 2024 Elsevier Inc.
PY - 2024/11
Y1 - 2024/11
N2 - Introduction: The diagnosis and management of biliary dyskinesia in children and adolescents remains variable and controversial. The American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee (APSA OEBP) performed a systematic review of the literature to develop evidence-based recommendations. Methods: Through an iterative process, the membership of the APSA OEBP developed five a priori questions focused on diagnostic criteria, indications for cholecystectomy, short and long-term outcomes, predictors of success/benefit, and outcomes of medical management. A systematic review was conducted, and articles were selected for review following Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Risk of bias was assessed using Methodologic Index for Non-Randomized Studies (MINORS) criteria. The Oxford Levels of Evidence and Grades of Recommendation were utilized. Results: The diagnostic criteria for biliary dyskinesia in children and adolescents are not clearly defined. Cholecystectomy may provide long-term partial or complete relief in some patients; however, there are no reliable predictors of symptom relief. Some patients may experience resolution of symptoms with non-operative management. Conclusions: Pediatric biliary dyskinesia remains an ill-defined clinical entity. Pediatric-specific guidelines are necessary to better characterize the condition, guide work-up, and provide management recommendations. Prospective studies are necessary to more reliably identify patients who may benefit from cholecystectomy. Level of Evidence: Level 3-4. Type of Study: Systematic Review of Level 3-4 Studies.
AB - Introduction: The diagnosis and management of biliary dyskinesia in children and adolescents remains variable and controversial. The American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee (APSA OEBP) performed a systematic review of the literature to develop evidence-based recommendations. Methods: Through an iterative process, the membership of the APSA OEBP developed five a priori questions focused on diagnostic criteria, indications for cholecystectomy, short and long-term outcomes, predictors of success/benefit, and outcomes of medical management. A systematic review was conducted, and articles were selected for review following Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Risk of bias was assessed using Methodologic Index for Non-Randomized Studies (MINORS) criteria. The Oxford Levels of Evidence and Grades of Recommendation were utilized. Results: The diagnostic criteria for biliary dyskinesia in children and adolescents are not clearly defined. Cholecystectomy may provide long-term partial or complete relief in some patients; however, there are no reliable predictors of symptom relief. Some patients may experience resolution of symptoms with non-operative management. Conclusions: Pediatric biliary dyskinesia remains an ill-defined clinical entity. Pediatric-specific guidelines are necessary to better characterize the condition, guide work-up, and provide management recommendations. Prospective studies are necessary to more reliably identify patients who may benefit from cholecystectomy. Level of Evidence: Level 3-4. Type of Study: Systematic Review of Level 3-4 Studies.
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U2 - 10.1016/j.jpedsurg.2024.08.018
DO - 10.1016/j.jpedsurg.2024.08.018
M3 - Review article
C2 - 39227244
AN - SCOPUS:85202967193
SN - 0022-3468
VL - 59
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 11
M1 - 161678
ER -