בשל "הגנת זכויות יוצרים" מובא להלן תקציר המאמר. ניתן לקרוא את הטקסט המלא בקישור בהתאם לספרייה הרפואית הזמינה לך
Kulaylat AN, Lucas DJ, Chang HL, Derderian SC, Beres AL, Ham PB 3rd, Huerta CT, Sulkowski JP, Wakeman D, Englum BR, Gulack BC, Acker SN, Gonzalez KW, Levene TL, Christison-Lagay E, Mansfield SA, Yousef Y, Pennell CP, Russell KW, Rentea RM, Tashiro J, Diesen DL, Alemayehu H, Ricca R, Kelley-Quon L, Rialon KL. Evaluation and Management of Biliary Dyskinesia in Children and Adolescents: A Systematic Review From the APSA Outcomes and Evidence-Based Committee. J Pediatr Surg. 2024 Nov;59(11):161678. doi: 10.1016/j.jpedsurg.2024.08.018. Epub 2024 Aug 14. PMID: 39227244.
Abstract
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.