SP 7.15 Outcomes of Operative and Non-operative Approaches in Biliary Dyskinesia: Evidence from a Systematic Review and Meta-Analysis
Faiza Hashim Soomro, Nadia Gulnaz, Mehwish Ansar, Izza NazirAbstract
Background
Biliary dyskinesia presents with biliary pain despite normal imaging, making management uncertain. While cholecystectomy is commonly performed, concerns about overuse and the unclear benefit over conservative treatment persist.
Material and Methods
This meta-analysis adhered to PRISMA guidelines and was registered prospectively in PROSPERO (CRD420251177002). Studies evaluating operative versus non-operative management of biliary dyskinesia were identified through searches of PubMed, Embase, Scopus, Cochrane and Clinicaltrials.gov. Risk of bias was assessed using the ROB 2.0 tool for randomized trials and the Newcastle–Ottawa Scale for observational studies.
Results
Six studies (one RCT, five observational) with a total of 326 patients met the inclusion criteria. Cholecystectomy resulted in significantly higher symptom resolution (RR 3.62; 95% CI 1.42–9.26) and markedly fewer persistent symptoms (RR 0.18; 95% CI 0.09–0.37). Quality-of-life outcomes consistently favored surgery, showing clear improvements in both physical and mental health scores compared with conservative management.
Conclusion
In adults with biliary-type pain and no gallstones, cholecystectomy provides superior symptom relief and quality-of-life improvement compared with nonoperative care, though careful patient selection and shared decision-making remain essential. Future studies using standardized entry criteria, imaging protocols, and patient-reported outcomes are needed to refine patient selection and optimize management.