Role of cholescintigraphy in management of acute acalculous cholecystitis

This study is aimed to evaluate the role of cholescintigraphy in management of acute acalculous cholecystitis.

A total of thirty two patients who had presented to the surgical out-patient department or referred from in-patient department or intensive care unit between February 2008 and February 2010 were studied. All patients with Ultrasonography abdomen findings of acalculous cholecystitis were included in the study and they underwent cholescintigraphy. Gall bladder ejection fraction (GBEF) was calculated 30 min after fatty meal. Patients who either had non-visualization of gall bladder or GBEF less than 40% were considered to have acalculous cholecystitis on cholescintigraphy. The patients were followed-up for a period of 3 months after the commencement of treatment.

Eleven patients had either non-visualization of gall bladder or GBEF < 40%. Of these, six patients underwent cholecystectomy and the rest were medically managed, as patients deferred surgery. 83.33% of post-cholecystectomy patients as against 40% of medically treated patients were symptom free. Twenty one patients had GBEF > 40%, 90.74% of these patients were symptom free at the end of 3 months, with medical management.

Cholescintigraphy is an important adjunct in management of patients with acalculous cholecystitis by guiding the course of therapy-surgical management versus medical management.