Abstract
Background: Endoscopic methods are well accepted as important treatments to clear the bile duct in patients with choledocholithiasis. However, little is known about bile dynamics after endoscopic treatment.
Objective: The aim of this study was to assess the hepatic clearance and gallbladder function using fatty meal Cholescintigraphy (CS) in patients after endoscopic treatment for choledocholithiasis.
Methods: Fatty meal CS was performed after intravenous injection of 8 mCi Tc-99m DISIDA. Hepatic clearance was calculated at 45 minutes (E45) after radiotracer injection. Gallbladder Ejection Fraction (GBEF) values were obtained at 30, 45, 60 and 75 minutes after fatty meal ingestion.
Results: Thirty-nine patients were recruited. E45 was 39.5 ± 12.7%, which was significantly lower than that in the cholecystectomized asymptomatic controls (66.2 ± 9%, p < 0.001) in our prior study. The gallbladder was not properly filled in 13 patients. The GBEF values at 30, 45, 60 and 75 minutes were 82.7 ± 14.6%, 90.4 ± 12.8%, 90.4 ± 11.1%, and 93.9 ± 9.2%, respectively. GBEF was lower in the presence of gallstones, which reached statistical significance at 45 minutes and 60 minutes in the comparison of patients with and without gallstones (p < 0.05).
Conclusion: Hepatic clearance in patients after endoscopic treatment for choledocholithiasis was generally lower. One-third of gallbladders lose their usual function. The GBEF was significantly reduced in the patients with gallstones. We suggested that GBEF with fatty meal stimulation could be used to follow patients after endoscopic treatment for choledocholithiasis.
Keywords: Choledocholithiasis, cholescintigraphy, gallbladder, ejection fraction, endoscopic, intravenous injection.
Graphical Abstract
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