Pain recurrence in patients with biliary Dyskinesia after Cholecystectomy

• Treatment of Biliary dyskinesia still does not have established clear guidelines. • Performed a retrospective cohort study regarding pain relief in patient with established biliary dyskinesia who underwent either medical or surgical treatment. • Our study showed laparoscopic cholecystectomy was ten times more likely to alleviate pain than medical treatment. Biliary dyskinesia is a more frequently diagnosed diseases of the biliary tree. Data is still lacking for guidelines to confirm whether medical or surgical treatment is optimal for this condition. The aim of this study is to evaluate the effectiveness of laparoscopic cholecystectomy for pain resolution in patients with biliary dyskinesia compared to non-operative conservative treatment. Our monocentric, retrospective study, between 2007 and 2022 included 63 patients admitted for biliary dyskinesia. Data was collected from patients’ files and the parameters considered were age, BMI, GBEF and severity of pain on diagnosis, as well as the modality of treatment and the response to treatment. Thirty-one out of 63 patients admitted for biliary dyskinesia were treated with cholecystectomy and thirty-two medically. Resolution of pain was observed in 80 % of patients treated surgically, compared to only 40 % among those managed conservatively. No correlation was found between BMI, GBEF, severity of pain on presentation and resolution of pain after treatment. A strong relationship exists between cholecystectomy and resolution of pain. Patients treated surgically are ten times more likely to experience resolution of their symptoms compared to those treated conservatively. Following the updated ROME IV criteria, biliary dyskinesia is now to be considered among the top differential diagnoses in patients with biliary colic symptoms. According to our study, cholecystectomy has shown to be an effective modality of treatment.