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Can J Rural Med. 2019 Apr-Jun;24(2):61-64. doi: 10.4103/CJRM.CJRM_28_18.

Laparoscopic cholecystectomy for ultrasound normal gallbladders: Should we forego hepatobiliary iminodiacetic acid scans?

Author information

1
Centre for Rural Health Studies, Faculty of Medicine, Memorial University of Newfoundland, Canada.

Abstract

in English, French

Introduction:

Hepatobiliary iminodiacetic acid (HIDA)-radionuclear scans are used to diagnose biliary dyskinesia, the treatment for which is a laparoscopic cholecystectomy (LC). However, the predictive value of the HIDA scan for LC candidacy is debated.

Case:

A physical, ultrasound, and blood test for a 53-year-old woman with biliary dyskinesia-like symptoms were normal, contradicting a textbook history. A HIDA-scan was ordered but the results suggested she was not eligible for a LC. The patient insisted on receiving the procedure and gave informed consent to undergo an elective LC.

Results:

Six-weeks post-surgery, the patient's symptoms had ceased besides one short episode of abdominal pain.

Conclusion:

A LC relieved the patient's symptoms, suggesting that negative HIDA-scans can mislead correct decisions to perform a LC. Surgeons who receive inconclusive HIDA scan results should consult their patients, and when necessary and agreed-upon, take an informed risk together in an attempt to improve the patient's quality of life.

KEYWORDS:

Biliary dyskinesia; HIDA scan; acalculous cholecystitis; chronic cholecystitis without stones; gallbladder dysfunction; symptomatic ultrasound normal gallbladders

PMID:
30924462
DOI:
10.4103/CJRM.CJRM_28_18
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