The role of sincalide cholescintigraphy in the evaluation of patients with acalculus gallbladder disease
J. Pickleman, R. L. Peiss, R. Henkin, B. Salo and P. Nagel
Thirty-six patients with biliary colic and normal oral cholecystograms,
upper gastrointestinal tract roentgenograms, and results of gallbladder
ultrasonography underwent sincalide-stimulated biliary excretion scanning.
Nineteen of these patients subsequently underwent cholecystectomies.
Gallbladder ejection fractions (EFs) ranged from 0% to 88% (mean, 38%) and
nine of 19 patients had exact pain reproduction with sincalide. All
patients except one (EF, 35%) were cured of their symptoms. However, five
patients were also cured who had a normal EF (greater than 50%).
Histologically, 11 gallbladders showed chronic cholecystitis and eight were
normal. We conclude that the sincalide biliary excretion scan is a useful
test to study this group of patients. In patients with a decreased EF,
cholecystectomy can be recommended with a high probability of symptom
relief. In patients with normal EFs, clinical judgment is required, as some
of these patients (five of five in this series) may still benefit from
operation.
