969 Assessment of Diagnostic Criteria and Treatment Approaches for Biliary Dyskinesia: A Retrospective Analysis in NHS Grampian

Abstract

Abstract Aim Biliary dyskinesia is a motility disorder of the gallbladder and sphincter of Oddi which presents with biliary-type pain without a structural pathology. Diagnosis relies on the ROME IV criteria for Functional Gallbladder Disorder, but its clinical utilisation remains limited. This retrospective study evaluates the diagnostic criteria, investigations, treatment, and surgical outcomes in patients with suspected biliary dyskinesia. Method Data from 185 patients who underwent cholecystokinin cholescintigraphy between 2017 and 2022 in NHS Grampian were analysed. Information on patient demographics, Rome IV criteria, supportive investigations, treatments, complications, hospital admissions, and medication use was collected from Trakcare. Results The average patient age was 46 years, with 21.1% male and 78.9% female participants. The Rome IV Criteria was used in only 12.4% of cases. Cholecystectomy was performed in 40.5% of cases, with complications occurring in 10.6% of these surgeries. On average, patients were admitted to the hospital 1.07 times, staying for approximately 3.92 days before surgery. Notably, 30.6% of cholecystectomy patients needed readmission for unresolved symptoms, and 40.5% relied on analgesics. Conclusions Rome IV criteria was underutilised in diagnosing biliary dyskinesia. Cholecystectomy did not reliably relieve symptoms in all patients, resulting in repeat admissions. Better adherence to diagnostic criteria and clear treatment guidelines are needed.