Laparoscopic cholecystectomy for biliary dyskinesia - Correlation of preoperative cholecystokinin cholescintigraphy results with postoperative outcome

Background: A gallbladder ejection fraction (EF) on cholescintigraphy of less than 35% after cholecystokinin (CCK) has been considered to be pathophysiologic and an indication for laparoscopic cholecystectomy (LC). Methods: All patients undergoing LC for biliary dyskinesia between 1994 and 2001 were prospectively entered into a database. These patients were retrospectively evaluated with regard to demographics, the number of preoperative studies obtained, postoperative symptoms, and the number of postoperative studies obtained. Results: Sixty patients underwent LC for biliary dyskinesia. The mean gallbladder EF was 14%, and 75% of patients were asymptomatic postoperatively. Persistent symptoms prompted further investigation in 6% of patients with a gallbladder EF < 14% and in 35% of patients with an EF between 14 and 35% (p = 0.05). Conclusion: Laparoscopic cholecystectomy alleviated symptoms in 94% of patients with a gallbladder EF < 14% after CCK injection. The diagnostic significance of a preoperative CCK cholescintigram (EF 14-35%) needs further investigation.