Improving Hepatobiliary Imaging as a Physiologic Test with Superior Clinical Outcomes.
Cholecystokinin
cholescintigraphy
fatty meal
gallbladder ejection fraction
hepatobiliary imaging
milk
Journal
World journal of nuclear medicine
ISSN: 1450-1147
Titre abrégé: World J Nucl Med
Pays: Germany
ID NLM: 101286955
Informations de publication
Date de publication:
Historique:
received:
21
02
2020
revised:
06
04
2020
accepted:
01
05
2020
entrez:
24
2
2021
pubmed:
25
2
2021
medline:
25
2
2021
Statut:
epublish
Résumé
This study aims at prospectively evaluating the difference in the effect of cholecystokinin (CCK) and half-and-half milk (HHM) administered in the same patient on gallbladder contractility and correlation with clinical outcomes. Upon gallbladder visualization during standard hepatobiliary imaging, 0.02 μg/kg of CCK was injected over 3 min, and additional 30 min of dynamic imaging was obtained. Patients with gallbladder ejection fraction (GBEF) <35% after CCK were administered 8 oz of HHM followed by 30 min of imaging. The GBEF was recalculated. The number of patients whom GBEF changed from below 35% (abnormal) after CCK to above 35% (normal) after HHM was recorded. Follow-up of the clinical outcome at 6 months was performed. Fifty patients with abnormal GBEF were prospectively included. The average GBEF after CCK was 14.7% ± 8.5% and after HHM was 30.7% ± 20.8%. The average increase in GBEF with HHM was 16.0% ± 22.2%. The GBEF changed from abnormal to normal in 17 patients (34%). The remaining 33 patients remained abnormal. Clinical outcomes at 6 months were available in 47 patients. Cholecystectomy was performed in 60% of patients with abnormal GBEF with CCK and HHM with resolution or improvement of pain. Two of 16 patients (12%) with abnormal GBEF after CCK but normal after HHM had cholecystectomies with pain improvement, while 8 out of these patients (50%) were diagnosed and treated with other disorders and improved. Hepatobiliary imaging with HHM stimulation is a superior physiologic test which can lower the number of unnecessary cholecystectomies and misdiagnoses as functional cholecystitis.
Identifiants
pubmed: 33623504
doi: 10.4103/wjnm.WJNM_21_20
pii: WJNM-19-353
pmc: PMC7875040
doi:
Types de publication
Journal Article
Langues
eng
Pagination
353-358Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR003167
Pays : United States
Informations de copyright
Copyright: © 2020 World Journal of Nuclear Medicine.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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