A Cochrane review included 1 study with 21 subjects with gallbladder dyskinesia (as diagnosed by an ejection fraction less than 40%, mean age 30.3 years, 91% of subjects were females). Open cholecystectomy was compared with observation. All the 11 patients in the cholecystectomy group showed improvement of pain symptoms compared with one patient in the control group (P = 0.0001) after a mean follow-up of 33.6 months (RR for failure of improvement in symptoms 0.05, 95% CI 0.00 to 0.74). 10 patients were cured of symptoms in the cholecystectomy compared with none in the control group (P = 0.0001; RR for failure of cure of symptoms 0.13, 95% CI 0.03 to 0.59). There was no mortality in either group. The procedure-related morbidity was not reported.
Comment: The quality of evidence is downgraded by study quality (lack of blinding and selective reporting of outcomes; the procedure-related morbidity was not reported), by potential reporting bias, and by imprecise results (few patients).