Role of 99mTc-EHIDA hepatobiliary scintigraphy in the eraluation of gallbladder contraction function before laparoscopic-hard endoscopic gallbladder-preserving cholecystolithotomy
10.3969/j.issn.1001-5256.2019.08.020
- VernacularTitle:放射性核素肝胆显像对腹腔镜联合硬镜微创保胆取石术前胆囊收缩功能的评估作用
- Author:
Dongfeng DUAN
1
;
Zhenyu YANG
;
Xilin DU
Author Information
1. Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an 710038, China
- Publication Type:Research Article
- Keywords:
cholecystolithiasis;
radionuclide imaging;
surgical procedures, minimally invasive
- From:
Journal of Clinical Hepatology
2019;35(8):1751-1754
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo 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. MethodsA 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. ResultsA 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. Conclusion99mTc-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.
