How to cure Acalcuous biliary pain

Acalcuous biliary pain
Acalculous is biliary colic occurring without gallstones resulting from structural or functional disorders, sometimes treated with laparoscopic cholecystectomy.

Biliary colic can occur in the absence of gallstones, particulary in young women. It accounts for up to 15% of laparoscopic cholecystectomies performed.

Common causes include microscopic stones, abnormal gallbladder motility, an overly sensitive biliary track , sphincter of Oddi dysfunction, hypersensitivity of the adjacent duodenum, and possibly , gallstones that have spontaneously passed . Some patients eventually develop other functional GI disorder.

A calculous biliary pain is suspected in patients with biliary colic whose test results reveal no gallstones.

Testing includes ultrasound and endoscopic ultrasound. To measure gallbladder emptying (ejection fraction), cholescintigraphy is performed after cholecystokinin infusion (while avoiding use of potentially interfering drugs such as Ca chanel blockers and anticholinergics).

To detect sphincter of Oddi dysfunction, ERCP with biliary manometry is performed.

To detect duodenal hypersensitivity, endoscopic barostat testing is performed but may be available only at research centers.

Laparoscopic cholecystectomy improves outcomes for microscopic stones and possibly abnormal gallbladder motility.

Whether abnormalities on other tests warrant laparoscopic cholecystectomy is under investigation

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