The Role of Sincalide Cholescintigraphy in the Evaluation of Patients With Acalculus Gallbladder Disease

Normal Values for Sincalide Cholescintigraphy: Comparison of Two Methods

“…Published investigations of sincalide use in cholescintigraphy for the diagnosis of CAC from 1980 to 1991 often used different values to define an abnormal GBEF, for example, less than 35% to less than 65% (1)(2)(3)(4)(5)(6)(7)(8)18). Where these values came from is often not certain.…”

“…Cholecystokinin (CCK) often is used to initiate gallbladder contraction, for example, prior to cholescintigraphy in patients who have been fasting for more than 24 hours or are receiving hyperalimentation and in patients who have undergone conventional cholescintigraphy to calculate a gallbladder ejection fraction (GBEF) to confirm the clinical diagnosis of chronic acalculous cholecystitis (CAC) (1)(2)(3)(4)(5)(6)(7)(8).…”

“…Investigators and clinicians have used very different infusion methods, such as total doses ranging from 0.005 to 0.04 g per kilogram of body weight and infusion durations of 30 seconds to 60 minutes (1)(2)(3)(4)(5)(6)(7)(8). The dose rate of 0.02 g/kg infused for 3 minutes became widely adopted after publication of a retrospective clinical investigation by Fink-Bennett et al in 1991 in which findings supported the use of CCK cholescintigraphy to diagnose CAC (3).…”

HIDA scan ejection fraction does not predict sphincter of Oddi hypertension or clinical outcome in patients with suspected chronic acalculous cholecystitis

“…Our position is that a normal HIDA EF does not exclude CAC and the benefit of cholecystectomy. Other authors are in agreement [29,37]. Each patient underwent a detailed history and physical exam prior to surgery.…”

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

“…In fact, controversy surrounds the distinction between normal and abnormal EF values. The majority of published studies suggest delineation is at approximately 35% (FinkBennett, et al, 1991;Yap, et al, 1991;Chen, et al, 2001;Davis, et al, 1982;Topper, et al, 1980;Pickleman, et al, 1985;FinkBennett, et al, 1985;Misra, et al, 1991;Zech, et al, 1991;Barron, et al, 1995;Yost, et al, 1999;Middleton & Williams, 1999;Poynter, et al, 2002;Majeski, et al, 2003).…”