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Certain organic substances change color in dilute solution when the hydronium ion concentration reaches a particular value. For example, phenolphthalein is a colorless substance in any aqueous solution with a hydronium ion concentration greater than 5.0 × 10−9 M (pH < 8.3). In more basic solutions where the hydronium ion concentration is less than 5.0 × 10−9 M (pH > 8.3), it is red or pink. Substances such as phenolphthalein, which can be used to determine the pH of a solution, are...
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The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
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Is hyperkinetic gallbladder an indication for cholecystectomy?

Shireesh Saurabh1, Benjamin Green2

  • 1General/Bariatric Surgery, Mercy Hospital, 540 East Jefferson Street, Suite 205, Iowa City, IA, 52245, USA. shireesh22@gmail.com.

Surgical Endoscopy
|September 14, 2018
PubMed
Summary
This summary is machine-generated.

Cholecystectomy effectively treats biliary colic in patients with hyperkinetic gallbladder, a condition characterized by high gallbladder ejection fraction (GBEF). This surgical intervention leads to significant symptom resolution in most patients.

Keywords:
CCK-HIDA scanChronic cholecystitisEjection fractionHyperkinetic gallbladderLaparoscopic cholecystectomy

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Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery
  • Diagnostic Imaging

Background:

  • Hepatobiliary imino diacetic acid (HIDA) scans are used for biliary colic diagnosis when ultrasounds are normal.
  • Biliary dyskinesia is defined by a low gallbladder ejection fraction (GBEF < 35-40%) on HIDA scans, typically managed with cholecystectomy.
  • Management guidelines for hyperkinetic gallbladder (GBEF > 80%) remain undefined.

Purpose of the Study:

  • To investigate the outcomes of cholecystectomy in patients experiencing biliary colic due to hyperkinetic gallbladder.

Main Methods:

  • Retrospective chart review of patients with hyperkinetic gallbladder who underwent cholecystectomy between July 2014 and February 2018.
  • Data collected included patient demographics, preoperative symptoms, comorbidities, diagnostic test results (including GBEF), surgical details, and histopathology.
  • Symptomatic improvement was assessed via 2-week postoperative visits and follow-up phone interviews.

Main Results:

  • Thirty-two patients with symptomatic hyperkinetic gallbladder underwent laparoscopic cholecystectomy.
  • The average GBEF was 92%, with 53% experiencing symptom exacerbation upon CCK infusion.
  • Pathology revealed chronic cholecystitis in 90% of patients. Post-surgery, 74% had complete symptom resolution, 16% improved, and 10% reported no change.

Conclusions:

  • Laparoscopic cholecystectomy is a favorable treatment for biliary colic associated with hyperkinetic gallbladder.
  • Patients with hyperkinetic gallbladder and biliary colic demonstrate significant symptomatic improvement following cholecystectomy.