title: Role of quantitative cholescintigraphy for planning laparoscopic cholecystectomy in patients with gallbladder dyskinesia and chronic abdominal pain.
abstract: Our aim was to examine the diagnostic role and therapeutic guide of quantitative cholescintigraphy in 122 patients with a biliary-type chronic abdominal pain and normal abdominal ultrasound. The patients with severe symptoms and an impaired ejection fraction (EF<or=35%) of the gallbladder in cholescintigraphy were operated by laparoscopic cholecystectomy (LC, n=32). The nonsurgical groups consisted of the patients with mild clinical symptoms and pathologic (<or=35%, n=52) or normal (>35%, n=38) EF. An impaired gallbladder emptying was found in 84/122 of patients (69%) and LC was performed in 32/122 (26%) of the patients, that is, 2.2% of all cholecystectomies in our hospital. After the mean follow-up of 4 years, chronic abdominal pain was totally improved or diminished in 92% in the LC group, 45% in the nonoperative group with EF<or=35%, and in 66% in the nonoperative group with EF>35%, respectively (P=0.0003). Quantitative cholescintigraphy is a useful aid when considering the treatment options in patients with chronic biliary-type abdominal pain and a negative abdominal ultrasound.
authors.affiliation: Department of Surgery, University Hospital of Kuopio, Kuopio, Finland. hannu.paajanen@esshp.fi
authors.forename: Hannu
authors.initials: H
authors.lastname: Paajanen
authors.forename: Sami
authors.initials: S
authors.lastname: Miilunpohja
authors.forename: Sarianna
authors.initials: S
authors.lastname: Joukainen
authors.forename: Jari
authors.initials: J
authors.lastname: Heikkinen
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000601:surgery*; D001657:Biliary Dyskinesia / Q000000981:diagnostic imaging* / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging