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Jack Pickleman, MD; Robert L. Peiss, MD; Robert Henkin, MD; Bruce Salo, MD; Philip Nagel, MD

Arch Surg. 1985;120(6):693-697.

Abstract
• 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 (>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.

(Arch Surg 1985;120:693-697)

Author Affiliations
From the Departments of Surgery (Dr Pickleman) and Nuclear Medicine (Drs Peiss, Henkin, and Salo), Loyola Stritch School of Medicine, Maywood, Ill. Dr Nagel is in private practice in Barrington, Ill.

Footnotes
Accepted for publication March 13, 1985.

Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 13, 1985.

Reprint requests to Department of Surgery, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153 (Dr Pickleman).

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