{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T21:36:33Z","timestamp":1776893793040,"version":"3.51.2"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,1,31]],"date-time":"2019-01-31T00:00:00Z","timestamp":1548892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gallbladder dyskinesia (gallbladder spasm, biliary dyskinesia or chronic acalculous cholecystitis) is a poorly defined entity which presents as biliary\u2010type pain without any identifiable organic pathology. Abnormal gallbladder ejection fraction (GBEF) is used by some to select those likely to benefit from cholecystectomy. The validity of this approach has been questioned.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To systematically review the literature and summarise the evidence surrounding the practice of cholecystectomy based on GBEF for gallbladder dyskinesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic search of PubMed\/MEDLINE and SCOPUS from 1980 to 2016 to identify the relevant literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010nine studies including 2891 patients were included in the final analysis. In comparing cholecystectomy with medical management, patients with a normal GBEF did not benefit from cholecystectomy; whereas those with low GBEF had a higher chance (RR, relative risk\u00a0=\u00a02.37) of symptomatic improvement following surgery. When those classified as \u201clow\u201d and \u201cnormal\u201d GBEF were compared in terms of outcome following cholecystectomy, the rate of improvement following surgery was similar in the two groups (RR 1.09) which suggests a placebo effect of surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While a low GBEF may provide some guidance in identifying those with gallbladder dyskinesia who may benefit from cholecystectomy, the available data are inconsistent and based on studies of poor quality which are often subject to bias and the impact of confounding factors. For these reasons, we conclude that the role of scintigraphy and cholecystectomy in the definition and management of this disorder remain unclear pending definitive study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15128","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T02:30:42Z","timestamp":1548988242000},"page":"654-663","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Systematic review with meta\u2010analysis: cholecystectomy for biliary dyskinesia\u2014what can the gallbladder ejection fraction tell us?"],"prefix":"10.1111","volume":"49","author":[{"given":"Vineet S.","family":"Gudsoorkar","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayah","family":"Oglat","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amita","family":"Jain","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Raza","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4151-7180","authenticated-orcid":false,"given":"Eamonn M. 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