title: Long-term follow-up of non-operated patients with symptomatic gallbladder stones: a retrospective study evaluating the role of Hepatobiliary scanning.
abstract: BACKGROUND
  To assess hepatobiliary (HB) scans for predicting recurrent symptoms in nonoperated patients with mild or vague symptomatic gallstones.
  
  
  METHODS
  Data of 170 patients with symptomatic gallstone and who had not undergone cholecystectomy were retrospectively enrolled. These patients were divided into two groups according to whether or not operations were performed due to recurrent symptoms during the follow-up period. The demographic factors and gallbladder ejection fraction (GBEF) of HB scans were compared between the groups. Additionally, symptom-free rate was obtained beginning from the date of the HB scan to the date of surgery, and analyzed based on the level of GBEF.
  
  
  RESULTS
  Among the 170 enrolled patients, two patients who underwent cholecystectomy for other disease were excluded. Thirty-four patients underwent cholecystectomy due to recurrent symptoms (OP group), and the remaining 136 patients did not experience recurrent symptoms and therefore did not undergo cholecystectomy (non-OP group). In the OP group, the mean GBEF was significantly lower than that of the non-OP group (28.8 ± 29.9 vs. 66.3 ± 20.0; P < 0.001). The rate of lower GBEF (<30 %, including non-visualization of the gallbladder) was significantly higher in the OP group than the non-OP group (54.9 vs. 5.1 %; P < 0.001). In patients with non-visualization of the gallbladder or GBEF <30 %, the 10-year symptom-free rate was significantly lower than those with a GBEF ≥ 30 % (19.8 % vs. 81.9 %; P < 0.001).
  
  
  CONCLUSIONS
  HB scanning is a useful objective modality to differentiate gallstone-related symptoms from other etiologies and predict recurrent symptoms.
authors.affiliation: Department of Surgery, Keimyung University Dongsan Medical Center, 56 Chungho-ro, Jung-gu, Daegu city,, 41931, Korea. ahnksmd@gmail.com.
authors.forename: Keun Soo
authors.initials: KS
authors.lastname: Ahn
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Korea, 300 Gumi-dong, Bundagn-gu, Seongnam city, Gyeonggido, 463-707, Korea. hanhs@snubh.org.
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Korea, 300 Gumi-dong, Bundagn-gu, Seongnam city, Gyeonggido, 463-707, Korea. jycho@snubh.org.
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Korea, 300 Gumi-dong, Bundagn-gu, Seongnam city, Gyeonggido, 463-707, Korea. yoonys@snubh.org.
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: Department of Nuclear Medicine, Korea University Ansan Hospital, Ansan city, Gyeonggido,, 425-707, Korea. chulhankim@kumc.or.kr.
authors.forename: Chulhan
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Korea, Gyeonggido, 463-707, Korea. wwlee@snubh.org.
authors.forename: Won Woo
authors.initials: WW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy; D005260:Female; D005500:Follow-Up Studies; D016473:Gallbladder Emptying / Q000502:physiology*; D042882:Gallstones / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012008:Recurrence; D012189:Retrospective Studies; D063189:Symptom Assessment / Q000379:methods*