{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:22:06Z","timestamp":1780489326452,"version":"3.54.1"},"reference-count":30,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Biliary dyskinesia is typically defined as a gallbladder ejection fraction (EF) &lt;35% on hepatobiliary iminodiacetic acid scan with cholecystokinin stimulation (CCK-HIDA) testing. Cholecystectomy often leads to resolution of associated biliary colic symptoms. Alternatively, there is a subset of symptomatic patients with normal gallbladder EF on CCK-HIDA. It has been proposed that pain with CCK injection is more predictive of symptom resolution after cholecystectomy than low gallbladder EF. We reviewed our experience with pediatric patients with positive CCK provocation testing and a normal gallbladder EF in the absence of gallstones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed the records of all pediatric patients with normal hepatobiliary iminodiacetic acid EFs (35%\u201380%) and pain with CCK injection at a tertiary care center between 2016 and 2020. Age, gender, body mass index (BMI), CCK-HIDA results, and pathology analysis were noted. Short- and long-term resolution of symptoms was determined by patient self-reporting at a mean of 3 weeks and 46 months, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seventeen patients met inclusion criteria. Average age was 15.1 years (range, 12\u201317 years) with median BMI 24.9 (\u00b1 4.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Mean CCK-HIDA EF was 56.3% (\u00b1 11.4%). In total, 62.5% of patients had evidence of chronic cholecystitis and\/or cholesterolosis on pathology analysis. Of patients available for short-term and long-term postoperative follow-up, 80% and 83% reported complete or near complete resolution of symptoms, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Normokinetic biliary dyskinesia is poorly understood but appears to be associated with chronic inflammation and cured by surgical intervention. Laparoscopic cholecystectomy results in resolution of symptoms for a majority of patients and should be considered in those with pain with CCK injection despite normal imaging studies. Clinical Trial Registration Number: 1657640-2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lap.2021.0349","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T11:28:10Z","timestamp":1649676490000},"page":"794-799","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Pediatric Normokinetic Biliary Dyskinesia: Pain with Cholecystokinin on Hepatobiliary Iminodiacetic Acid Scan Predictive of Symptom Resolution After Cholecystectomy"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7234-9303","authenticated-orcid":false,"given":"Jillian C.","family":"Jacobson","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie E.","family":"Bosley","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wake Forest School of Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela W.","family":"Gaffley","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wake Forest School of Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Pediatrix - Dallas Pediatric Surgical Associates, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas P.","family":"Neff","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Wake Forest Baptist Medical Center, Brenner Children's Hospital, Winston-Salem, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,7,4]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2016.05.005"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(99)00063-X"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.04.040"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.06.052"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.02.017"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481808400939"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480807401106"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480807400704"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2001.26379"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(99)90388-3"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-004-1234-3"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.02.032"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(99)90387-1"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.02.034"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2015.03.056"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-013-3343-3"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2019.01.011"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.epsc.2013.08.010"},{"key":"e_1_3_4_20_2","first-page":"882","article-title":"Hyperkinetic gallbladder: An indication for cholecystectomy?","author":"Lindholm EB","unstructured":"Lindholm EB, , Alberty JB, , Hansbourgh F, , Upp JR, , Lopoo J. 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