Diagnostic value of gallbladder emptying variables in chronic acalculous cholecystitis as assessed by fatty meal cholescintigraphy.

OBJECTIVE: The main purpose of this study was to determine the diagnostic value of gallbladder emptying variables in chronic acalculous cholecystitis (CAC). The variables investigated were latent period, gallbladder ejection fraction (GBEF) and patterns of gallbladder emptying. In addition, two other biliary system motility variables were investigated including the onset of gallbladder filling and biliary-to-bowel transit time.

METHODS: Thirty-nine healthy volunteers underwent fatty meal cholescintigraphy (CS) prospectively to determine the normal values of these variables. Retrospectively, fatty meal CS studies of 88 patients suspected of having CAC were retrieved and reprocessed to obtain corresponding values of these variables, which then compared with normal values.

RESULTS: The mean onset of gallbladder filling for patient groups was not significantly different from volunteer group mean. The mean+/-SD GBEF value for CAC group (29+/-20%) was significantly lower than volunteer group value (54+/-23%), whereas for non-CAC group (60+/-21%) it was not significantly different. The latent period was found invariable and not significant in CAC diagnosis. Two patterns of gallbladder emptying were noted: ended and continuous. The pattern of gallbladder emptying did not affect the mean GBEF and was found insignificant in the diagnosis of CAC. There was no significant difference in the number of cases with late biliary-to-bowel transit time between the groups.

CONCLUSION: The single most important gallbladder emptying variable in diagnosing CAC is the GBEF. The latent period and the pattern of gallbladder emptying as well as the onset of gallbladder filling and biliary-to-bowel transit time are of no significant diagnostic value in CAC.