title: HIDA scan for functional gallbladder disorder: ensure that you know how the scan was done.
abstract: BACKGROUND
  Despite the increasing use of fatty meal (FM) as a substitute for cholecystokinin (CCK) in pain reproduction during hepato-imino-diacetic acid (HIDA) scan in functional gallbladder disorder, there are no studies comparing the differences between CCK and FM. The present study was to compare the efficacy of FM in comparison of CCK in FGBD application.
  
  
  METHODS
  Patients undergoing HIDA scans from August 2013 to May 2014 were divided into two groups: those undergoing CCK-stimulated HIDA scan versus FM-stimulated HIDA scan. These groups were compared according to demographics and HIDA results.
  
  
  RESULTS
  Of 153 patients, 70 received CCK and 83 FM. There was no difference regarding age, gender, gallstones, gallbladder ejection fraction and time to visualization. However, significantly more of the patients receiving CCK than FM experienced pain reproduction (61% vs 30%, P<0.01).
  
  
  CONCLUSIONS
  Stimulation of gallbladder contractility with a FM during HIDA is less than half as likely to reproduce biliary symptoms compared to CCK, despite similar ejection fractions and other parameters. It is essential that providers account for this difference when counseling patients regarding cholecystectomy for functional gallbladder disorder.
authors.affiliation: Department of Surgery, Saint Agnes Hospital, Baltimore, USA. Steven.Cunningham@stagnes.org.
authors.forename: Naeem
authors.initials: N
authors.lastname: Goussous
authors.forename: Hadia
authors.initials: H
authors.lastname: Maqsood
authors.forename: Ethan
authors.initials: E
authors.lastname: Spiegler
authors.forename: Gopal C
authors.initials: GC
authors.lastname: Kowdley
authors.forename: Steven C
authors.initials: SC
authors.lastname: Cunningham
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001657:Biliary Dyskinesia / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D002763:Cholecystectomy; D002766:Cholecystokinin / Q000008:administration & dosage / Q000009:adverse effects; D004041:Dietary Fats / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007098:Imino Acids / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D014812:Vitamin K / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D004041:Dietary Fats; C029401:Ensure Plus; D007098:Imino Acids; D019275:Radiopharmaceuticals; D014812:Vitamin K; D002766:Cholecystokinin; C049470:lidofenin