Role of 99mTc-EHIDA hepatobiliary scintigraphy in the eraluation of gallbladder contraction function before laparoscopic-hard endoscopic gallbladder-preserving cholecystolithotomy

• Main Author: DUAN Dongfeng
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2019-08-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=10090

Objective To investigate the role of radionuclide hepatobiliary scintigraphy in the evaluation of gallbladder contraction function, and to provide a theoretical basis for preoperative evaluation of gallbladder contraction function in patients undergoing laparoscopic-hard endoscopic gallbladder-preserving cholecystolithotomy. Methods A total of 47 patients with gallstones who were admitted to The Second Affiliated Hospital of Air Force Medical University from June to December, 2016, and underwent 99mTc-EHIDA hepatobiliary imaging to evaluate gallbladder contraction function were enrolled. The radioactive count of the gallbladder was measured after fat meal and gallbladder contraction function was evaluated. A comparative analysis was performed based on intraoperative exploration and gallbladder-preserving outcome. Results A total of 26 patients with negative results of the EHIDA gallbladder contraction test underwent a successful gallbladder-preserving surgery, and some of them had no recurrence of stones after 24 months of follow-up. Among the 12 patients with impaired gallbladder contraction function shown by EHIDA, 1 underwent cholecystectomy due to roughness of the gallbladder wall and deposition of a large amount of cholesterol crystal, and 11 underwent gallbladder-preserving cholecystolithotomy. Among the 9 patients without the image of the gallbladder, 1 was found to have stones with a diameter of 2 cm embedded in the neck of the gallbladder by intraoperative exploration and underwent gallbladder-preservation surgery, and no recurrence of gallbladder stones was observed after 24 months of follow-up; the remaining 8 patients underwent cholecystectomy. Conclusion 99mTc-EHIDA hepatobiliary scintigraphy has a certain value in evaluating gallbladder contraction function, but it cannot be used as the only evidence for the selection of surgical approach. Laparoscopic-hard endoscopic intraoperative exploration is a strong evidence for the selection of gallbladder-preserving surgery, and formal industry standards can be developed.