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Clinical application of the cholecystokinin provocation test
1University Department of Surgery, Royal Infirmary, Glasgow, UK.
The British Journal of Surgery
|May 1, 1988
Summary
Cholecystokinin (CCK) provocation tests lack clear evidence for diagnosing acalculous biliary pain and guiding gallbladder removal surgery. Further research is needed to clarify their clinical utility in patient assessment.
Area of Science:
- Gastroenterology
- Biliary tract disease
- Diagnostic procedures
Background:
- Acalculous biliary pain presents a diagnostic challenge.
- Cholecystokinin (CCK) provocation tests are sometimes used.
- Gallbladder removal (cholecystectomy) is a common treatment.
Purpose of the Study:
- To review the diagnostic value of CCK provocation tests.
- To assess the evidence for CCK in acalculous biliary pain.
- To inform clinical decision-making regarding cholecystectomy.
Main Methods:
- Literature review of studies on CCK provocation tests.
- Analysis of conflicting reports on test efficacy.
- Evaluation of evidence supporting CCK use in biliary pain assessment.
Main Results:
- Conflicting reports exist regarding CCK test value.
- No definitive evidence supports CCK provocation tests.
- Uncertainty remains about CCK's role in diagnosing biliary pain.
Conclusions:
- The utility of CCK provocation tests for acalculous biliary pain is not well-established.
- Current evidence does not unequivocally support using CCK tests to decide on cholecystectomy.
- Clinical decisions for cholecystectomy should consider limitations of CCK testing.
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