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Does gallbladder ejection fraction predict outcome after cholecystectomy for suspected chronic acalculous gallbladder
John K DiBaise1, Dmitry Oleynikov
1Department of Internal Medicine, Section of Gastroenterology and Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE 68198-2000, USA.
The American Journal of Gastroenterology
|December 23, 2003
Summary
The gallbladder ejection fraction (GBEF) calculation
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Surgical Outcomes
Background:
- Chronic acalculous gallbladder dysfunction (CAGD) diagnosis is challenging.
- Cholecystokinin-cholescintigraphy with gallbladder ejection fraction (GBEF) calculation is used, but its clinical utility is debated.
Purpose of the Study:
- To critically evaluate the existing literature on the utility of GBEF in predicting outcomes for patients with suspected CAGD.
Main Methods:
- A comprehensive literature search of MEDLINE (1980-2002) and manual reference checks was performed.
- Twenty-three English-language articles on adult patients were included.
- Data on study design, methodology, interventions, and outcomes were extracted.
Main Results:
- All included studies were of poor methodologic quality, predominantly retrospective case series.
- Significant heterogeneity existed in GBEF cut-off values, technique reporting, and outcome measures.
- Despite limitations, 19 studies suggested GBEF utility in predicting outcomes after cholecystectomy.
Conclusions:
- The use of GBEF for diagnosing CAGD and predicting treatment outcomes is not adequately studied.
- While many studies report GBEF utility, high-quality evidence is lacking, preventing definitive recommendations.
- Further high-quality clinical trials are necessary to establish the role of GBEF.
