Role of quantitative cholescintigraphy for planning laparoscopic cholecystectomy in patients with gallbladder dyskinesia and chronic abdominal pain.
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.
Paajanen
Hannu
H
Department of Surgery, University Hospital of Kuopio, Kuopio, Finland. hannu.paajanen@esshp.fi
Miilunpohja
Sami
S
Joukainen
Sarianna
S
Heikkinen
Jari
J
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