Cholescintigraphy in the determination of disturbed hepatobiliary function in acute cholecystitis

The hepatobiliary transit of 99mTc-diethyl-IDA was studied in 50 cases of acute cholecystitis. The intrahepatic transit was characterized by the liver mean transit time of the tracer. The extrahepatic passage through the biliary tract was assessed from a series of scintigrams. The data were classified according to previously obtained knowledge of normal and pathological states of the liver and the biliary tract. (Normal liver mean transit time less than or equal to 70 minutes, normal appearance-time of the tracer in the biliary tract less than or equal to 15 minutes and in the intestine less than or equal to 20 minutes, no retention of the tracer in the biliary tract in cases of later appearance-times). Abnormal hepatobiliary transit of the tracer was recorded in 27 cases; it was retarded at the intrahepatic level in 11 cases, at the gallbladder neck in 3 cases, distally in the biliary tract in 12 cases, and a tight extrahepatic obstruction was seen in 1 case. In consequence, acute cholecystitis is often associated with disturbed hepatobiliary function. The functional changes in acute cholecystitis were similar to those associated with other hepatobiliary disorders of either intrahepatic or extrahepatic origin.