Quantitative cholescintigraphy with fatty meal in

Authors: Sampath Santhosh Bhagwant Rai Mittal Sasikumar Arun Ashwani Sood Anish Bhattacharya Rakesh Kochhar

Publish Date: 2012/09/02

Volume: 31, Issue: 4, Pages: 186-190

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Abstract

To evaluate the role of quantitative cholescintigraphy with fatty meal in the management of biliary dyskinesia and to describe the findings according to Sostre score SS criteria in patients with gallbladder GB insitu and biliary pain We performed a retrospective analysis of the hepatobiliary HIDA studies n = 35 performed for evaluation of biliary dyskinesia either due to biliary pain opioid induced sphincter of Oddi dysfunction SOD recurrent pancreatitis RP or post cholecystectomy syndrome PCS Gallbladder ejection fraction GBEF was calculated from the post fatty meal HIDA images excluding PCS patients Studies with GBEF ≤40  and SS 4 were considered to have cholecystopathy and SOD respectively Three of the 13 patients with PCS had SS of 6 each suggestive of SOD Delayed biliary visualization 15 min and activity in common bile duct 60 min  liver15 min were the specific features in these cases Opioid induced SOD patients had SS 4 with retrograde refilling of GB in one patient and normalization of the SS parameters after nifedipine challenge in the other patient Patients with RP and biliary pain were stratified into four groups normal GBEF 40  and SS ≤4 cholecystopathy GBEF ≤40  and SS ≤4 normal with SOD GBEF 40  and SS 4 and cholecystopathy with SOD GBEF ≤40  and SS 4 Four patients with intact GB had cholecystopathy with scintigraphic features of SOD Quantitative cholescintigraphy with fatty meal and SS scoring identified biliary dyskinesia and SOD in patients with biliary pain recurrent pancreatitis and postcholecystectomy syndrome

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