The surgeon usually needs to be sure about the diagnosis before any action is taken. First, all diseases and conditions that might have the same symptoms as biliary dyskinesia should probably be excluded : hepatitis, cholecystitis, choledocolithiasis, cholelithiasis, gastritis, peptic ulcer of the stomach or duodenum, pancreatitis, tumors, etc. This process normally requires several diagnostic tests and procedures (liver profile, standard blood analyses, âHelicobacter piloriâ-serolgy, ultrasound, HIDA-scanning, CD-scanning, and endoscopy). If all these tests are negative and the HIDA-scan shows gallbladder ejection fraction less then 35%, then laparoscopic cholecystectomy may be indicated. The surgeon will decide on that. Finally, fatty and spicy foods usually provoke gallbladder attacks.