Gall bladder Dyskinesia / Biliary Dyskinesia

What is Biliary Dyskinesia?

Biliary dyskinesia or gallbladder dyskinesia is a motility disorder of the biliary system in which the bile does not drain out well from the gallbladder. Bile is a dark green to yellowish-brown fluid, secreted by the liver and stored in the gallbladder. A muscular valve called sphincter of Oddi controls the movement of bile from the gallbladder (through the bile duct) to small intestine. A metabolic disorder of the gallbladder or dysfunction of sphincter of Oddi may disrupt the normal movement of bile causing it to backflow into the gallbladder.

Symptoms

The symptoms of biliary dyskinesia include:

  • Pain in the right upper abdomen after meals that lasts for more than 30 minutes
  • Intermittent pain throughout the day
  • Severe pain that prevents routine activities of daily living
  • Nausea
  • Fever
  • Poor appetite
  • Indigestion
  • Bloating
  • Weight loss or weight gain

Risk factors

The possible risk factors of biliary dyskinesia include:

  • Advanced age
  • Obesity
  • Female gender
  • Stress
  • Gallbladder inflammation
  • Gastrointestinal disease
  • Hypothyroidism

Diagnosis

Your doctor will assess your symptoms and perform a physical exam. The following diagnostic tests or procedures may be ordered:

  • Liver Function Test: Determines the health of your liver, gallbladder and bile ducts.
  • Cholecystokinin Hepatobiliary (CCK-HIDA) Scan: A small amount of radioactive dye and enzyme cholecystokinin is injected followed by a fatty meal. A nuclear medicine camera helps your doctor see how well bile is secreted from your gallbladder.
  • Imaging Tests: Images of your gallbladder are obtained by performing CT scan, MRI, Ultrasound, etc.
  • Endoscopic Retrograde Cholangiography (ERCP): An endoscope is inserted into your mouth and advanced towards the stomach and duodenum (first part of your small intestine). A dye is injected and X-ray images are taken to study your bile ducts.

Treatment

Prescription pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) are used to manage pain. Surgery may be recommended to remove your gallbladder.

Laparoscopic cholecystectomy:

It is the surgical removal of the gallbladder laparoscopically. A laparoscope is a thin fibre-optic device fitted with a camera and lens. Images from the camera are transmitted to a large monitor for your doctor to view the inside of your body.

The procedure involves the following steps:

  • The surgery is performed under general anaesthesia.
  • You will lie on your back (supine position).
  • Your surgeon makes small cuts in the upper abdomen.
  • A laparoscope is inserted through one of the incisions.
  • Special tools are used by your surgeon to isolate the gall bladder duct (cystic duct) and artery.
  • The gallbladder is separated from the liver and carefully removed.
  • The incision is closed and a bandage is applied.
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