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Related Concept Videos

Acute Pancreatitis I: Introduction01:27

Acute Pancreatitis I: Introduction

Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Cholecystitis01:20

Cholecystitis

Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
Acute Pancreatitis I: Introduction01:25

Acute Pancreatitis I: Introduction

Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
Acute Pancreatitis II: Pathophysiology01:21

Acute Pancreatitis II: Pathophysiology

The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...

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Related Experiment Video

Updated: Jul 5, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

A requiem for the cholecystokinin provocation test?

A Smythe1, A W Majeed, M Fitzhenry

  • 1Department of Surgical and Anaesthetic Sciences, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.

Gut
|November 21, 1998
PubMed
Summary

The cholecystokinin provocation test (CCKPT) does not reliably predict symptom relief after gallbladder removal for acalculous biliary pain. This test should not be used for evaluating patients with this condition.

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Published on: August 18, 2016

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Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
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Published on: November 25, 2025

Area of Science:

  • Gastroenterology
  • Biliary tract disease
  • Diagnostic testing

Background:

  • Acalculous biliary pain is a challenging diagnosis.
  • The cholecystokinin provocation test (CCKPT) has been proposed to predict outcomes after cholecystectomy.
  • Its predictive value in acalculous biliary pain remains uncertain.

Purpose of the Study:

  • To evaluate the predictive accuracy of the CCKPT for symptom relief following cholecystectomy.
  • To assess outcomes in both CCKPT-positive and CCKPT-negative patients.

Main Methods:

  • Fifty-eight patients with acalculous biliary pain underwent CCKPT with ultrasound volumetry.
  • Patients underwent cholecystectomy or conservative management based on CCKPT results and symptom persistence.
  • CCKPT was repeated six months post-cholecystectomy.

Main Results:

  • Among 32 CCKPT-positive patients who had surgery, 67% achieved symptom relief.
  • Of 26 CCKPT-negative patients, 9 became symptom-free without surgery, and 42.8% of those undergoing surgery improved.
  • No significant difference in symptom relief was observed between preoperative CCKPT-positive and negative groups.

Conclusions:

  • The CCKPT did not demonstrate predictive value for symptomatic benefit after cholecystectomy in acalculous biliary pain.
  • Current evidence suggests discontinuing the use of CCKPT in the diagnostic workup for acalculous biliary pain.