Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 1551  
 
ORIGINAL ARTICLE
Ahead of Print

Improving Hepatobiliary Imaging as a Physiologic Test with Superior Clinical Outcomes


1 Departments of Diagnostic and Interventional Imaging, Nuclear Medicine Section, University of Texas, Houston, Texas, USA
2 Department of Internal Medicine, UTHealth McGovern Medical School, University of Texas, Houston, Texas, USA
3 Department of Gastroenterology, UTHealth McGovern Medical School, University of Texas, Houston, Texas, USA
4 Department of Surgery, UTHealth McGovern Medical School, University of Texas, Houston, Texas, USA

Correspondence Address:
Isis W Gayed,
Department of Diagnostic and Interventional Imaging Nuclear Medicine Section, McGovern Medical School, University of Texas, Houston, Texas
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wjnm.WJNM_21_20

This study aims at prospectively evaluating the difference in the effect of cholecystokinin (CCK) and half-and-half milk (HHM) administered in the same patient on gallbladder contractility and correlation with clinical outcomes. Upon gallbladder visualization during standard hepatobiliary imaging, 0.02 μg/kg of CCK was injected over 3 min, and additional 30 min of dynamic imaging was obtained. Patients with gallbladder ejection fraction (GBEF) <35% after CCK were administered 8 oz of HHM followed by 30 min of imaging. The GBEF was recalculated. The number of patients whom GBEF changed from below 35% (abnormal) after CCK to above 35% (normal) after HHM was recorded. Follow-up of the clinical outcome at 6 months was performed. Fifty patients with abnormal GBEF were prospectively included. The average GBEF after CCK was 14.7% ± 8.5% and after HHM was 30.7% ± 20.8%. The average increase in GBEF with HHM was 16.0% ± 22.2%. The GBEF changed from abnormal to normal in 17 patients (34%). The remaining 33 patients remained abnormal. Clinical outcomes at 6 months were available in 47 patients. Cholecystectomy was performed in 60% of patients with abnormal GBEF with CCK and HHM with resolution or improvement of pain. Two of 16 patients (12%) with abnormal GBEF after CCK but normal after HHM had cholecystectomies with pain improvement, while 8 out of these patients (50%) were diagnosed and treated with other disorders and improved. Hepatobiliary imaging with HHM stimulation is a superior physiologic test which can lower the number of unnecessary cholecystectomies and misdiagnoses as functional cholecystitis.


Print this article
Search
 Back
 
  Search Pubmed for
 
    -  Gayed IW
    -  Dawood L
    -  Xu Z
    -  Rizk G
    -  Dupont A
    -  Atta M
    -  Robinson EK
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed59    
    PDF Downloaded16    

Recommend this journal