Improving Hepatobiliary Imaging as a Physiologic Test with Superior Clinical Outcomes

Area of Science:

• Hepatobiliary Imaging
• Gastroenterology
• Diagnostic Medicine

Background:

• Gallbladder contractility is crucial for digestive health.
• Abnormal gallbladder ejection fraction (GBEF) can cause pain and lead to misdiagnosis.
• Cholecystokinin (CCK) is a standard stimulant, but its efficacy is debated.

Purpose of the Study:

• To compare the effects of CCK and half-and-half milk (HHM) on gallbladder contractility.
• To evaluate the correlation between GBEF changes and clinical outcomes.
• To assess HHM as a superior diagnostic tool for gallbladder function.

Main Methods:

• Prospective evaluation of 50 patients with abnormal GBEF after CCK.
• Administration of HHM to patients with GBEF <35% post-CCK.
• Dynamic imaging to recalculate GBEF and 6-month clinical outcome follow-up.

Main Results:

• Average GBEF increased from 14.7% (CCK) to 30.7% (HHM).
• GBEF normalized in 17 patients (34%) after HHM stimulation.
• Cholecystectomy resolved pain in 60% of patients with persistent abnormal GBEF.

Conclusions:

• HHM stimulation is a more effective physiologic test for gallbladder contractility.
• HHM can help reduce unnecessary cholecystectomies and misdiagnoses of functional gallbladder disorders.
• This approach improves diagnostic accuracy for biliary pain.