[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
August 1991

Results of Surgical Therapy for Biliary Dyskinesia

Author Affiliations

From the Departments of Surgery (Drs Misra, Blossom, and Glover) and Nuclear Medicine (Dr Fink-Bennett), William Beaumont Hospital, Royal Oak, Mich.

Arch Surg. 1991;126(8):957-960. doi:10.1001/archsurg.1991.01410320039003
Abstract

• One hundred eighty-seven patients who presented with symptoms consistent with biliary colic but had no ultrasonic evidence of cholelithiasis were observed in an effort to identify those with a functional gallbladder disorder that might benefit from surgical intervention. All patients underwent quantitative evaluation of gallbladder emptying using cholecystokinin biliary scanning, and ejection fractions less than 35% were considered abnormal. One hundred twenty-nine patients (69%) had abnormal ejection fractions, and 88 (68%) of these subsequently underwent cholecystectomy. Sixty of the surgical specimens revealed pathologic changes. Eighty-four percent of patients successfully contacted for follow-up experienced complete relief, and another 13% had partial relief of preoperative symptoms. Only two patients reported no change in symptom complex. Twenty-nine patients with abnormal ejection fractions elected not to undergo surgery. Fifty-nine percent of these patients continued to experience symptoms of biliary colic at a mean follow-up of 22 months. Of the 44 patients with normal ejection fractions, 35 (80%) reported resolution of symptoms during follow-up of medical treatment. Cholecystokinin biliary scanning can help identify patients with acalculous, functional gallbladder disease who may benefit from cholecystectomy.

(Arch Surg. 1991;126:957-960)

References
1.
Krishnamurthy GT, Bobba VR, Kingston E, Turner F.  Measurement of gallbladder emptying sequentially using a single dose of 99mTc-labeled hepatobiliary agent . Gastroenterology . 1982;83:773-776.
2.
Mesgarzedeh M, Krishnamurthy GT, Bobba VE, Langrell K.  Filling, postcholecystokinin emptying, and refilling normal gallbladder: effects of two different doses of CCK on refilling . J Nucl Med . 1983;24:666-671.
3.
Fink-Bennett D, DeRidder P, Kolozsi W, Gordon R, Rapp J.  Cholecystokinin (CCK) functional cholescintigraphy (FC) in patients suspected of acalculous biliary disease (ABD) . J Nucl Med . 1984;25:10.
4.
Fink-Bennett D, DeRidder P, Kolozsi W, Gordon R, Rapp J.  Cholecystokinin (CCK) cholescintigraphy (C) in acalculous biliary disease (ABD) . J Nucl Med . 1986;27:882.
5.
Swayne L, Palace F, Rothenberg J, Heitner D, Trevino J.  Sensitivity (SENS), specificity (SPEC), and accuracy (ACC) of CCK cholescintigraphy (CCK-C) in acalculous biliary disease (ABD) . J Nucl Med . 1986;27:882.
6.
McFarland JO, Currin JS.  Cholecystokinin and cystic duct syndrome . Am J Gastroenterol . 1969;52:515-522.
7.
Moskovitz M, Min TC, Gavaler JS.  The microscopic examination of bile in patients with biliary pain and negative imaging tests . Am J Gastroenterol . 1986;81:329-333.
8.
Pitt HA, Roslyn JJ, Kuchenbecker SL, Doty JE, DenBesten L.  The role of cystic duct resistance in the pathogenesis of cholesterol gallstones . J Surg Res . 1981;30:508-514.Article
9.
Roslyn JJ, DenBesten L, Pitt HA, Kuchenbecker S, Polarek JW.  Effects of cholecystokinin on gallbladder stasis and cholesterol gallstone formation . J Surg Res . 1981;30:200-204.Article
10.
Rajagopalan AE, Pickleman J.  Biliary colic and functional gallbladder disease . Arch Surg . 1982;117:1005-1008.Article
11.
Pickleman J, Peiss RL, Henkin R, Salo B, Nagel P.  The role of sincalide cholescintigraphy in the evaluation of patients with acalculus gallbladder disease . Arch Surg . 1985;120:693-697.Article
12.
Fink-Bennett D.  The role of cholecystogogues in the evaluation of biliary tract disorders . In: Freeman LM, Weissman HS, eds. Nucl Med Annu . New York, NY: Raven Press; 1985:107-132.
13.
Proudfoot R, Mattingly SS, Snodgrass S, Griffen WO.  Cholecystokinin cholecystography: is it a useful test? South Med J . 1985;78:1443-1446.Article
14.
Rhodes M, Lennard TWJ, Farndon JR, Taylor RMR.  Cholecystokinin (CCK) provocation test: long-term follow-up after cholecystectomy . Br J Surg . 1988;75:951-953.Article
×