Does gallbladder ejection fraction predict outcome after cholecystectomy for suspected chronic acalculous gallbladder dysfunction? A systematic review

Dibaise, John K.; Oleynikov, Dmitry
December 2003
American Journal of Gastroenterology;Dec2003, Vol. 98 Issue 12, p2605
Academic Journal
The clinical utility of cholecystokinin-cholescintigraphy with calculation of a gallbladder ejection fraction (GBEF) in patients with suspected chronic acalculous gallbladder dysfunction (CAGD) remains controversial. It was our aim to critically evaluate the literature on the utility of the GBEF to predict outcome of patients with suspected CAGD. We performed an electronic search of the MEDLINE database for articles published between 1980 and 2002 and a manual search of references from bibliographies of identified articles. Only articles in English that concerned adults were screened. Data extracted included both qualitative and quantitative data reported on the study groups, cholescintigraphic technique, interventions, treatment outcomes, and trial methodologic characteristics. Twenty-three publications met the inclusion criteria. All were considered of poor methodologic quality. All but three studies were retrospective case series, only one was randomized, and none were adequately blinded, used adequate controls, or enrolled a sufficient number of patients. Five studies used a cut-off value for an abnormal GBEF that was different than the value used by the others, one study did not provide a cut-off value, and several did not report details of the cholescintigraphic technique (namely, the rate of cholecystokinin infusion). Studies varied in their outcome measures and the criteria for success. The overall assessment of outcome in 19 studies concluded that calculation of a GBEF was useful in patients with suspected CAGD. The low methodologic quality of the studies precluded a meta-analysis approach to the data Use of a calculated GBEF to diagnose and predict treatment outcome in suspected CAGD has not been adequately studied. Although most studies report utility of GBEF in predicting symptom outcome after cholecystectomy in patients with suspected CAGD, quality evidence is lacking, thereby precluding a definitive recommendation regarding its use. More high quality trials are needed.


Related Articles

  • Selective Blockade of Cholecystokinin Type B Receptors with L-365,260 Does not Impair Gallbladder Contraction in Normal Humans. Grasing, K.; Freedholm, D.; Murphy, M. G.; Swigar, M.; Russer, T.; Nosher, J.; Lin, J.; Frame, V.; Clarke, L.; Seibold, J. R. // American Journal of Gastroenterology;Mar1996, Vol. 91 Issue 3, p569 

    Objectives: To evaluate the effect of selective blockade of type B cholecystokinin receptors on gall bladder contraction in normal humans and to compare methods for quantitative analysis of gall bladder contraction. Methods: L-365,260, a novel, nonpeptide cholecystokinin antagonist shown to be...

  • SCINTIGRAPHY IN GALLBLADDER DISEASE: HOPE OR HYPE? Hacker III, Joseph F.; Johnson, David A.; Cattau Jr., Edward L. // American Journal of Gastroenterology;Aug1992, Vol. 87 Issue 8, p1056 

    Studies the application of scintigraphy in patients with gallbladder disease. Details of the subject of the study; Results of the histologic analysis of the removed specimen; Discussion on the results of the study.

  • Short- and long-term outcomes following percutaneous cholecystostomy for acute cholecystitis in high-risk patients. McKay, Andrew; Abulfaraj, Moaz; Lipschitz, Jeremy // Surgical Endoscopy;May2012, Vol. 26 Issue 5, p1343 

    Background: Percutaneous cholecystostomy is a less invasive method to treat acute cholecystitis in patients who are critically ill or have serious medical comorbidities precluding the use of general anesthesia. It remains controversial whether interval cholecystectomy is warranted. The...

  • Sludge and stone formation in the gallbladder in bedridden elderly patients with cerebrovascular disease: influence of feeding method. Onizuka, Yasunori; Mizuta, Yohei; Isomoto, Hajime; Takeshima, Fuminao; Murase, Kunihiko; Miyazaki, Masanobu; Ogata, Hirofumi; Otsuka, Kikuo; Murata, Ikuo; Kohno, Shigeru // Journal of Gastroenterology;2001, Vol. 36 Issue 5, p330 

    Purpose. The incidence of gallbladder sludge or gallstone formation in bedridden patients with cerebrovascular disease (CVD) remains obscure. The aim of this study was to determine the incidence, relationship to feeding method, and mechanisms of gallbladder sludge and gallstone formation in...

  • Single-Port Transumbilical Laparoscopic Cholecystectomy: A Preliminary Study in 37 Patients with Gallbladder Disease. Sang Kuon Lee; Young Kyoung You; Jung Hyun Park; Hyung-Jin Kim; Kyung Keun Lee; Dong Goo Kim // Journal of Laparoendoscopic & Advanced Surgical Techniques;Aug2009, Vol. 19 Issue 4, p495 

    Introduction: Since the introduction of laparoscopic surgery, surgeons have not only been concerned about clinical outcomes, but also surgical scars. Although natural orifice transluminal endoscopic surgery (NOTES) is promising, it is not applicable to clinical practice thus far due to safety...

  • TG13 management bundles for acute cholangitis and cholecystitis. Okamoto, Kohji; Takada, Tadahiro; Strasberg, Steven; Solomkin, Joseph; Pitt, Henry; Garden, O.; B├╝chler, Markus; Yoshida, Masahiro; Miura, Fumihiko; Kimura, Yasutoshi; Higuchi, Ryota; Yamashita, Yuichi; Mayumi, Toshihiko; Gomi, Harumi; Kusachi, Shinya; Kiriyama, Seiki; Yokoe, Masamichi; Lau, Wan-Yee; Kim, Myung-Hwan // Journal of Hepato -- Biliary -- Pancreatic Sciences;Jan2013, Vol. 20 Issue 1, p55 

    Bundles that define mandatory items or procedures to be performed in clinical practice have been increasingly used in guidelines in recent years. Observance of bundles enables improvement of the prognosis of target diseases as well as guideline preparation. There were no bundles adopted in the...

  • Single-Fulcrum Laparoscopic Cholecystectomy in Uncomplicated Gallbladder Diseases: A Retrospective Comparative Analysis with Conventional Laparoscopic Cholecystectomy. Ho Kyoung Hwang; Sung Hoon Choi; Chang Moo Kang; Woo Jung Lee // Yonsei Medical Journal;Nov2013, Vol. 54 Issue 6, p1471 

    Purpose: Single-fulcrum laparoscopic cholecystectomy (SFLC) is a variant type of single incision and multi-port technique that does not use specialized one-port devices or articulating instruments. We retrospectively compared perioperative outcomes of SFLC with those of conventional laparoscopic...

  • A Comparison Between Single-Incision and Conventional Laparoscopic Cholecystectomy. Kim, Beom Su; Kim, Kab Choong; Choi, Youn Baik // Journal of Laparoendoscopic & Advanced Surgical Techniques;Jul/Aug2012, Vol. 22 Issue 6, p443 

    Background: Single-incision laparoscopic surgery is becoming a more widely accepted surgical approach. However, the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC) are yet to be established. The present study compared outcomes following the use of SILC or...

  • Acute cholecystitis: the golden 72-h period is not a strict limit to perform early cholecystectomy. Results from 316 consecutive patients. Degrate, Luca; Ciravegna, Arianna Libera; Luperto, Margherita; Guaglio, Marcello; Garancini, Mattia; Maternini, Matteo; Giordano, Laura; Romano, Fabrizio; Gianotti, Luca; Uggeri, Franco // Langenbeck's Archives of Surgery;Dec2013, Vol. 398 Issue 8, p1129 

    Purpose: Early laparoscopic cholecystectomy (ELC) is the treatment of choice for acute cholecystitis (AC), but the optimal surgical timing is controversial. The aim of this study was to retrospectively verify the outcome of patients with AC according to different timing of cholecystectomy....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics