Reproducibility of Gallbladder Ejection Fraction Measured by Fatty Meal Cholescintigraphy

Abstract

Purpose There are conflicting data in the literature regarding the reproducibility of the gallbladder ejection fraction (GBEF) measured by fatty meal cholescintigraphy (CS). We aimed to test the reproducibility of GBEF measured by fatty meal CS. Methods Thirty-five subjects (25 healthy volunteers and 10 patients with chronic abdominal pain) underwent fatty meal CS twice in order to measure GBEF1 and GBEF2. The healthy volunteers underwent a repeat scan within 1-13 months from the first scan. The patients underwent a repeat scan within 1-4 years from the first scan and were not found to have chronic acalculous cholecystitis (CAC). Our standard fatty meal was composed of a 60-g Snickers chocolate bar and 200 ml full-fat yogurt. Results The mean ± SD values for GBEF1 and GBEF2 were 52±17% and 52±16%, respectively. There was a direct linear correlation between the values of GBEF1 and GBEF2 for the subjects, with a correlation coefficient of 0.509 (p=0.002). Subgroup data analysis of the volunteer group showed that there was significant linear correlation between volunteer values of GBEF1 and GBEF2, with a correlation coefficient of 0.473 (p=0.017). Subgroup data analysis of the non-CAC patient group showed no significant correlation between patient values of GBEF1 and GBEF2, likely due to limited sample size. Conclusions This study showed that fatty meal CS is a reliable test in gallbladder motility evaluation and that GBEF measured by fatty meal CS is reproducible.

Fatty meal sonography comparing coconut oil and chocolate bar with full-fat yoghurt as cholecystagogues for gallbladder ejection fractions

“…The GBEF for the chocolate bar and yoghurt combination was the highest of the cholecystagogues (62.84%), comparable with previous studies. 20 The GBEF was 23.47% for 20 g of coconut oil and 5.11% for 15 g of coconut oil.…”

“…The number of participants, although limited, was comparable to previous studies. 20 Because of the nature of the study, diabetics were excluded from the study. The coconut oil could not be benchmarked against intravenous CCK, as intravenous CCK is not available in South Africa.…”

Oral Cholecystagogue Cholescintigraphy

“…Meal composition varied widely, including dried egg yolk, 13 milk, [14][15][16][17] half milk and half cream, 18,19 Lipomul (corn oil emulsion marketed by Upjohn and discontinued in 1979), 20 corned beef and cheese sandwich, 12 bacon roll, 21 a candy bar, 22 and dietary supplements. 23 In 1 study, sham feeding was used, involving chewing of food, without ingestion.…”

Relations between hepatobiliary scintigraphy findings and histopathological factors in patients with recurrent biliary colic

“…Second, a fatty meal stimulation was used to measure GBEF. While GBEF measured by fatty meal stimulation is known to be reproducible, 31 the normal range and threshold value of GBEF may be different from those measured by hepatobiliary scintigraphy with cholecystokinin stimulation, 1,8 indicating that further validation of our results is required. Finally, we only evaluated the relationship between hepatobiliary scintigraphy findings and histopathological results without assessing their relationship to clinical outcomes.…”