Skip to main content
Top
Published in: Surgical Endoscopy 5/2004

01-05-2004 | Original article

Laparoscopic cholecystectomy for biliary dyskinesia

Correlation of preoperative cholecystokinin cholescintigraphy results with postoperative outcome

Authors: J. Bingener, M. L. Richards, W. H. Schwesinger, K. R. Sirinek

Published in: Surgical Endoscopy | Issue 5/2004

Login to get access

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.
Literature
1.
go back to reference Adams, DB, Tamasky, PR, Hawes, RH, Cunningham, JT, Brooker, C, Brothers, TE, cotton, PB 1998Outcome after laparoscopic cholecystectomy for chronic acalculous cholecystitis.Am Surg6415PubMed Adams, DB, Tamasky, PR, Hawes, RH, Cunningham, JT, Brooker, C, Brothers, TE, cotton, PB 1998Outcome after laparoscopic cholecystectomy for chronic acalculous cholecystitis.Am Surg6415PubMed
2.
go back to reference Blalock, A 1924A statistical study of eight hundred and eighty-eight cases of biliary tract disease.Johns Hopkins Hosp Bull35391409 Blalock, A 1924A statistical study of eight hundred and eighty-eight cases of biliary tract disease.Johns Hopkins Hosp Bull35391409
3.
go back to reference Canfield, AJ, Hetz, SP, Schriver, JP, Servis, HT, Hovenga, TL, Cirangle, PT, Burlingame, BS 1998Biliary dyskinesia: a study of more than 200 patients and review of the literature.J Gastrointest Surg2443448CrossRefPubMed Canfield, AJ, Hetz, SP, Schriver, JP, Servis, HT, Hovenga, TL, Cirangle, PT, Burlingame, BS 1998Biliary dyskinesia: a study of more than 200 patients and review of the literature.J Gastrointest Surg2443448CrossRefPubMed
4.
go back to reference Chen, PF, Nimeri, A, Pham, QH, Yuh, JN, Gusz, JR, Chung, RS 2001The clinical diagnosis of chronic cholecystitis.Surgery130578581 Chen, PF, Nimeri, A, Pham, QH, Yuh, JN, Gusz, JR, Chung, RS 2001The clinical diagnosis of chronic cholecystitis.Surgery130578581
5.
go back to reference Fink-Bennett, D, DeRidder, P, Kolozsi, WZ, Gordon, R, Jaros, R 1991Cholecystokinin cholescintigraphy: detection of abnormal gallbladder motor function in patients with chronic acalculous gallbladder disease.J Nucl Med3216951699PubMed Fink-Bennett, D, DeRidder, P, Kolozsi, WZ, Gordon, R, Jaros, R 1991Cholecystokinin cholescintigraphy: detection of abnormal gallbladder motor function in patients with chronic acalculous gallbladder disease.J Nucl Med3216951699PubMed
6.
go back to reference Frasinelli, P, Werner, M, Reed, JF,3rd, Scagliotti, C 1998Laparoscopic cholecystectomy alleviates pain in patients with acalculous biliary disease.Surg Lap Endosc Perc Tech83034CrossRef Frasinelli, P, Werner, M, Reed, JF,3rd, Scagliotti, C 1998Laparoscopic cholecystectomy alleviates pain in patients with acalculous biliary disease.Surg Lap Endosc Perc Tech83034CrossRef
7.
go back to reference Friedman, JB, Cohen, WN 1975Cholecystokinin cholangiography and analysis of duodenal bile in the investigation of pain in the right upper quadrant of the abdomen without gallstones.Surg Gynecol Obstet140371376PubMed Friedman, JB, Cohen, WN 1975Cholecystokinin cholangiography and analysis of duodenal bile in the investigation of pain in the right upper quadrant of the abdomen without gallstones.Surg Gynecol Obstet140371376PubMed
8.
go back to reference Jones, DB, Soper, NJ, Brewer, JD, Quasebath, MA, Swanson, PE, Strasberg, SM, Brunt, LM 1996Chronic acalculous cholecystitis: laparoscopic treatment.Surg Lap Endosc Perc Tech6114122CrossRef Jones, DB, Soper, NJ, Brewer, JD, Quasebath, MA, Swanson, PE, Strasberg, SM, Brunt, LM 1996Chronic acalculous cholecystitis: laparoscopic treatment.Surg Lap Endosc Perc Tech6114122CrossRef
9.
go back to reference Jones-Monahan, K, Gruenberg, JC 1999Chronic acalculous cholecystitis: changes in patient demographics and evaluation since the advent of laparoscopy.J Soc Laparoendosc Surg3221224 Jones-Monahan, K, Gruenberg, JC 1999Chronic acalculous cholecystitis: changes in patient demographics and evaluation since the advent of laparoscopy.J Soc Laparoendosc Surg3221224
10.
go back to reference Kloiber, R, Molnar, CP, Shaffer, EA 1992Chronic biliary-type pain in the absence of gallstones: the value of cholecytokinin cholescintigraphy.Am J Roentgenol159509513 Kloiber, R, Molnar, CP, Shaffer, EA 1992Chronic biliary-type pain in the absence of gallstones: the value of cholecytokinin cholescintigraphy.Am J Roentgenol159509513
11.
go back to reference Krishnamurthy, GT, Bobba, VR, Langrell, K 1984The gallbladder emptying response to sequential exogenous and endogenous cholecystokinin.Nucl Med Commun52733PubMed Krishnamurthy, GT, Bobba, VR, Langrell, K 1984The gallbladder emptying response to sequential exogenous and endogenous cholecystokinin.Nucl Med Commun52733PubMed
12.
go back to reference Merg, AR, Kalinowski, SE, Hinkhouse, MM, Mitros, FA, Ephgrafe, KS, Cullen, JJ 2002Mechanisms of impaired gallbladder contractile response in chronic acalculous cholecystitis.J Gastrointest Surg6432437CrossRefPubMed Merg, AR, Kalinowski, SE, Hinkhouse, MM, Mitros, FA, Ephgrafe, KS, Cullen, JJ 2002Mechanisms of impaired gallbladder contractile response in chronic acalculous cholecystitis.J Gastrointest Surg6432437CrossRefPubMed
13.
go back to reference Raptopoulos, V, Compton, CC, Doherty, P, Smith, EH, D’Orsi, CJ, Patwardhan, NA, Goldberg, R 1986Chronic acalculous gallbladder disease: multiimaging evaluation with clinical–pathologic correlation.Am J Roentgenol147721724 Raptopoulos, V, Compton, CC, Doherty, P, Smith, EH, D’Orsi, CJ, Patwardhan, NA, Goldberg, R 1986Chronic acalculous gallbladder disease: multiimaging evaluation with clinical–pathologic correlation.Am J Roentgenol147721724
14.
go back to reference Sarva, RP, Shreiner, DP, Thiel, D, Yingvorapant, N 1985Gallbladder function. Methods for measuring filling and emptying.J Nucl Med26140146PubMed Sarva, RP, Shreiner, DP, Thiel, D, Yingvorapant, N 1985Gallbladder function. Methods for measuring filling and emptying.J Nucl Med26140146PubMed
15.
go back to reference Schwesinger, WH, Diehl, AK 1996Changing indications for laparoscopic cholecystectomy. Stones without symptoms and symptoms without stones.Surg Clin North Am76493504PubMed Schwesinger, WH, Diehl, AK 1996Changing indications for laparoscopic cholecystectomy. Stones without symptoms and symptoms without stones.Surg Clin North Am76493504PubMed
16.
go back to reference Tabet, J, Anvari, M 1999Laparoscopic cholecystectomy for gallbladder dyskinesia: clinical outcome and patient satisfaction.Surg Lap Endosc Perc Tech9382386CrossRef Tabet, J, Anvari, M 1999Laparoscopic cholecystectomy for gallbladder dyskinesia: clinical outcome and patient satisfaction.Surg Lap Endosc Perc Tech9382386CrossRef
17.
go back to reference Westlake, PJ, Hershfield, NB, Kelley, JK, Kloiber, R, Lui, R, Sutherland, LR, Shaffer, EA 1990Chronic right upper quadrant pain without gallstones: does HIDA scan predict outcome after cholecystectomy?Am J Gastroenterol85986990PubMed Westlake, PJ, Hershfield, NB, Kelley, JK, Kloiber, R, Lui, R, Sutherland, LR, Shaffer, EA 1990Chronic right upper quadrant pain without gallstones: does HIDA scan predict outcome after cholecystectomy?Am J Gastroenterol85986990PubMed
18.
go back to reference Whipple, AO 1926Surgical criteria for cholecystectomy.Am J Surg40129139 Whipple, AO 1926Surgical criteria for cholecystectomy.Am J Surg40129139
19.
go back to reference Yap, L, Wycherley, AG, Morhett, AD, Toouli, J 1991Acalculous biliary pain: cholecystectomy alleviates symptoms in patients with abnormal cholescintigraphy.Gastroenterology101786793PubMed Yap, L, Wycherley, AG, Morhett, AD, Toouli, J 1991Acalculous biliary pain: cholecystectomy alleviates symptoms in patients with abnormal cholescintigraphy.Gastroenterology101786793PubMed
20.
go back to reference Yost, F, Margenthaler, J, Presti, M, Burton, F, Murayama, K 1999Cholecystectomy is an effective treatment for biliary dyskinesia.Am J Surg178462465PubMed Yost, F, Margenthaler, J, Presti, M, Burton, F, Murayama, K 1999Cholecystectomy is an effective treatment for biliary dyskinesia.Am J Surg178462465PubMed
21.
go back to reference Ziessman, HA 2001Cholecystokinin cholescintigraphy. Clinical indications and proper methodology.Rad Clin North Am399971006 Ziessman, HA 2001Cholecystokinin cholescintigraphy. Clinical indications and proper methodology.Rad Clin North Am399971006
Metadata
Title
Laparoscopic cholecystectomy for biliary dyskinesia
Correlation of preoperative cholecystokinin cholescintigraphy results with postoperative outcome
Authors
J. Bingener
M. L. Richards
W. H. Schwesinger
K. R. Sirinek
Publication date
01-05-2004
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 5/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-8145-6

Other articles of this Issue 5/2004

Surgical Endoscopy 5/2004 Go to the issue