Optimum utilization of cholecystokinin cholescintigraphy (CCK-HIDA) in clinical practice: an evidence based review

Laparoscopic cholecystectomy remains one of the most commonly performed operations in the United States. Of the cholecystectomies performed, approximately 30% are carried out for a diagnosis of gallbladder dyskinesia, for which diagnosis is based on a reduced gallbladder ejection fraction as determined by a sincalide (cholecystokinin) stimulated hepatobiliary iminodiacetic scan (CCK-HIDA). Despite the widespread acceptance of this practice standardization of the test methodology and high quality data indicating efficacy of cholecystectomy in the treatment of this condition are lacking. This manuscript reviews this problem in detail based on the current available literature.