Hepatobiliary and pancreatic surgery: biliary dyskinesia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary and pancreatic surgery: biliary dyskinesia

Sample item

A 30-year-old woman has recurrent post-prandial right upper quadrant pain. Ultrasound shows no gallstones, liver tests are normal and endoscopy is normal. A cholecystokinin-stimulated HIDA scan shows a very low gallbladder ejection fraction that reproduces her pain. What is the most appropriate treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Laparoscopic cholecystectomy

Biliary dyskinesia with a low ejection fraction and reproduced symptoms is treated by cholecystectomy after other causes are excluded. A normal duct and normal liver tests make sphincterotomy or bypass unnecessary.

Option by option

  • A. Endoscopic sphincterotomy

    Sphincterotomy treats sphincter of Oddi dysfunction, which is not demonstrated here.

  • B. Hepaticojejunostomy

    Bypass is for strictures and has no role in a normal duct.

  • C. Laparoscopic cholecystectomy (correct)

    Correct. Cholecystectomy relieves symptoms in biliary dyskinesia with an abnormal ejection fraction.

  • D. Long-term ursodeoxycholic acid

    Ursodeoxycholic acid dissolves small cholesterol stones, and none are present.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Laparoscopic cholecystectomy. Biliary dyskinesia with a low ejection fraction and reproduced symptoms is treated by cholecystectomy after other causes are excluded.

Why is "Endoscopic sphincterotomy" not the answer?

Sphincterotomy treats sphincter of Oddi dysfunction, which is not demonstrated here.

Why is "Hepaticojejunostomy" not the answer?

Bypass is for strictures and has no role in a normal duct.

Why is "Long-term ursodeoxycholic acid" not the answer?

Ursodeoxycholic acid dissolves small cholesterol stones, and none are present.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: biliary dyskinesia in General Surgery. A normal duct and normal liver tests make sphincterotomy or bypass unnecessary.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary and pancreatic surgery: biliary dyskinesia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.