The Cholecystokin Provocation HIDA Test: Recreation of Symptoms is Superior to Ejection Fraction in Predicting Medium-Term Outcomes

Morris‐Stiff, Gareth; Falk, Gavin A.; Kraynak, Laurel; Rosenblatt, Steven

doi:10.1007/s11605-010-1342-4

Cited by 40 publications

(28 citation statements)

References 38 publications

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“…Our results show that presence of chronic inflammation and favorable outcome after CCY was accurately predicted by presence of chronic biliary symptoms. These findings are concordant with other published studies (Fuller, et al, 2000;Morris-Stiff, et al, 2011).…”

Section: Discussionsupporting

confidence: 94%

“…Morris-Stiff and colleagues reported 25 patients with normal EF but recreation of symptoms upon CCK injection who underwent CCY. All patients reported complete resolution of symptoms at followup (Morris-Stiff, et al, 2011). We hypothesize that patients with normal TUS, normal HIDA scan EF, and chronic biliarylike pain will benefit from CCY.…”

Section: Introductionmentioning

confidence: 84%

See 1 more Smart Citation

Hepatobiliary scanning standards fail to identify symptomatic patients with chronic acalculous cholecystitis

Stanley

Wright

Davenport

et al. 2015

MRAJ

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Background: Patients with chronic biliary colic-like pain and normal transabdominal ultrasonography (TUS) typically undergo nuclear hepatobiliary imaging (HIDA) with cholecystokinin (CCK) injection and gall bladder ejection fraction (EF) calculation to identify gallbladder dyskinesia. Most literature suggests EF≤35% indicates biliary dyskinesia. We hypothesize that presence of chronic biliary colic-like symptoms predicts favorable outcome after cholecystectomy (CCY) in patients with normal hepatobiliary imaging.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 84%

Hepatobiliary scanning standards fail to identify symptomatic patients with chronic acalculous cholecystitis

Stanley

Wright

Davenport

et al. 2015

MRAJ

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“…By contrast, Morris-Stiff et al [68], studying 42 patients who underwent CCY based on symptom reproduction at CCK injection (17 with GBEF <35%, and 25 with normal GBEF), found that 100% of the patients with reproduction of symptoms upon CCK injection had relief of the biliary symptoms following CCY; no patients without symptom reproduction were included in the study. Another study, by Canfield et al [69], did include patients both with and without reproduction of symptoms on CCK injection and both with and without abnormal (<50%) GBEF.…”

Section: Treatmentmentioning

confidence: 99%

Gallbladder Dysfunction: How Much Longer Will It Be Controversial?

Goussous¹,

Kowdley²,

Sardana³

et al. 2014

Digestion

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Background: Motility disorders of the biliary tree [biliary dyskinesia, including both gallbladder dysfunction (GBD), and sphincter of Oddi dysfunction] are difficult to diagnose and to treat. Summary: There is controversy in the literature in particular regarding the criteria that should be used to select patients for cholecystectomy (CCY) in cases of suspected GBD. The current review covers the history, diagnosis, and treatment of GBD. Key Messages: Only >85% of patients with suspected GBD have relief following CCY, a much lower rate than the nearly 100% success rate following CCY for gallstone disease. Unfortunately, the literature is lacking, and there are no universally agreed-upon criteria for selecting which patients to refer for operation, although cholecystokinin (CCK)-enhanced hepatobiliary iminodiacetic acid scan is often used, with emphasis on an abnormally low gallbladder ejection fraction or pain reproduction at CCK administration. There is a clear need for large, well-designed, more definitive, prospective studies to better identify the indications for and efficacy of CCY in cases of GBD. i 2014 S. Karger AG, Basel

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“…[6][7][8][9][10][11] Some recent studies have questioned the predictive value of gallbladder ejection fraction and have suggested that the reproduction of symptoms with cholecystokinin is more likely to predict symptomatic relief from cholecystectomy. 12,13 The encouraging results from these studies, however, are based on short-term surgical followup. The surgical literature is lacking long-term data on the recurrence of symptoms following cholecystectomy for biliary dyskinesia.…”

Section: Introductionmentioning

confidence: 99%