J Bingener1, M L Richards, W H Schwesinger, K R Sirinek. 1. Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7842, San Antonio, TX 78229-3900, USA. bingenercas@uthscsa.edu
Abstract
BACKGROUND: A gallbladder ejection fraction (EF) on cholescintigraphy of less than 35% after cholecystokinin (CCK) has been considered to be pathophysiologic and an indication for laparoscopic cholecystectomy (LC). METHODS: All patients undergoing LC for biliary dyskinesia between 1994 and 2001 were prospectively entered into a database. These patients were retrospectively evaluated with regard to demographics, the number of preoperative studies obtained, postoperative symptoms, and the number of postoperative studies obtained. RESULTS: Sixty patients underwent LC for biliary dyskinesia. The mean gallbladder EF was 14%, and 75% of patients were asymptomatic postoperatively. Persistent symptoms prompted further investigation in 6% of patients with a gallbladder EF <14% and in 35% of patients with an EF between 14 and 35% (p = 0.05). CONCLUSION: Laparoscopic cholecystectomy alleviated symptoms in 94% of patients with a gallbladder EF <14% after CCK injection. The diagnostic significance of a preoperative CCK cholescintigram (EF 14-35%) needs further investigation.
BACKGROUND: A gallbladder ejection fraction (EF) on cholescintigraphy of less than 35% after cholecystokinin (CCK) has been considered to be pathophysiologic and an indication for laparoscopic cholecystectomy (LC). METHODS: All patients undergoing LC for biliary dyskinesia between 1994 and 2001 were prospectively entered into a database. These patients were retrospectively evaluated with regard to demographics, the number of preoperative studies obtained, postoperative symptoms, and the number of postoperative studies obtained. RESULTS: Sixty patients underwent LC for biliary dyskinesia. The mean gallbladder EF was 14%, and 75% of patients were asymptomatic postoperatively. Persistent symptoms prompted further investigation in 6% of patients with a gallbladder EF <14% and in 35% of patients with an EF between 14 and 35% (p = 0.05). CONCLUSION: Laparoscopic cholecystectomy alleviated symptoms in 94% of patients with a gallbladder EF <14% after CCK injection. The diagnostic significance of a preoperative CCK cholescintigram (EF 14-35%) needs further investigation.
Authors: Anders R Merg; Scott E Kalinowski; Marilyn M Hinkhouse; Frank A Mitros; Kimberly S Ephgrave; Joseph J Cullen Journal: J Gastrointest Surg Date: 2002 May-Jun Impact factor: 3.452
Authors: A J Canfield; S P Hetz; J P Schriver; H T Servis; T L Hovenga; P T Cirangle; B S Burlingame Journal: J Gastrointest Surg Date: 1998 Sep-Oct Impact factor: 3.452
Authors: Bernabé M Quesada; Gustavo Kohan; Hernán E Roff; Carlos M Canullán; Luis T Chiappetta Porras Journal: World J Gastroenterol Date: 2010-05-07 Impact factor: 5.742
Authors: Robert B Dorman; Wei Zhong; Anasooya A Abraham; Sayeed Ikramuddin; Waddah B Al-Refaie; Daniel B Leslie; Elizabeth B Habermann Journal: Obes Surg Date: 2013-11 Impact factor: 4.129
Authors: Hayder H Al-Azzawi; Attila Nakeeb; Romil Saxena; Mary A Maluccio; Henry A Pitt Journal: J Gastrointest Surg Date: 2007-07 Impact factor: 3.452