Variables affecting quantitative biliary scintigraphy in asymptomatic cholecystectomized volunteers

Quantitative cholescintigraphy has been used to evaluate biliary emptying and, by some, as a screening test for sphincter of Oddi dyskinesia in cholecystectomized patients. Our aim was to identify variables that might effect the interpretation of the scintigraphy in asymptomatic cholecystectomized volunteers.

Quantitative cholescintigraphy was performed in 37 volunteer. There were 11 males and 26 females with a median age of 49 years (range: 32-82). The time interval from cholecystectomy ranged from 1 month to 30 years (median: 5 years). Eight subjects had also undergone choledocholithotomy during the cholecystectomy operation.

From the time of the injection of the radioisotope to the maximum activity in the liver, the percentage of clearance and the hepatic hilum-duodenal transit time were measured to be 45 and 60 min, respectively. The maximum activity obtained in the liver was 17 +/- 10 min (mean +/- SD), and the percentage of clearance at 45 min was 52 +/- 22% and at 60 min 67 +/- 20%. Hilum-duodenal transit time was 12 +/- 11 min. The gender of the volunteer and previous choledocholithotomy did not correlate with the parameters studied. The age of the volunteer and the follow-up time had a positive correlation to the time of maximum activity and negative correlation to percentage of clearance. The follow-up time also had a positive correlation to hilum-duodenal transit time. In the multivariate analysis, the time interval since cholecystectomy was the only independent variable affecting study parameters.

The length of the time interval since cholecystectomy but not the gender, age, or previous choledocholithotomy should be taken into consideration when the results of quantitative cholescintigraphy are interpreted.