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Biliary Dyskinesia (1.4%EF) Mixed Opinions from DR's
I had a HIDA scan done about a month ago, after having severe symptoms the past 5 months. These symptoms include: Severe back pain, pain under right ribs that sometimes radiates outward, feeling of fullness when eating, burping often when eating, nausea, chills, fatigue. (These symptoms were accompanied by GERD, which my DR put me on Nexium for.)
The HIDA scan showed an Ejection Fraction rate of 1.4% which my doctor said was EXTREMELY low. She explained that it works at such a low level that it basically fills with bile, but cannot empty. She very casually said I should have it removed, and referred me to a surgeon that I had to wait 3 weeks to see. In the meantime, I consulted with my other doctor and he suggested that I have it out ASAP. I asked if there were any danger in waiting or leaving it in and he said it was possible that it could become so backed up it could become an emergency (leading me to the emergency room.) Both of the Dr's agreed that I should be on a low to no fat diet while I wait to have surgery. However, though this low to no fat diet is reducing symptoms (though there is a constant 'full' feeling under my right ribs- like something swollen is under there), I am losing weight rather quickly (12 pounds in just under 3 weeks.) I was a normal weight to begin with, and am a little nervous about losing any more weight.) Then, when I spoke to the surgeon, she acknowledged that yes it did function at a surprisingly low rate, but there was no emergency, and that the worst I'd have to deal with while waiting for surgery is the pain and discomfort I have been experiencing thus far. The earliest I can get in for surgery is two weeks from now. My question is, is there any sense of emergency, or any likelihood that something bad could happen while waiting? Each Dr seemed to have a different opinion on the urgency of my gallbladder disease. Is there any risk of becoming septic, or the gallbladder getting so full it leaks or explodes or...?
With all due respect, surgical advice from non-surgeons is rather suspect. In patients with gallbladder disease with gallstones present, the chances of potentially life threatening complications is about one in three without surgery. This is the real reason symptomatic patients should undergo cholecystectomy. In patients with non-stone disease (dyskinesia), there is no data to suggest that there is a high incidence of complications. In this population, it is the symptoms themselves that indicate surgery. The only thing lost by delaying surgery some is pain-free days.
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