What is gallbladder dyskinesia? How does cholescintigraphy evaluate the emptying of the gallbladder?
A significant number of patients with normal conventional imaging and clinical evaluation have pain referable to the gallbladder, as evidenced by relief of symptoms after cholecystectomy. The poorly understood and heterogeneous entity of gallbladder dyskinesia has been proposed as the cause of this pain. It is thought that poorly coordinated contractions between the gallbladder and cystic duct can cause pain. Gallbladder dyskinesia may be manifested by an abnormally low ejection of bile under the stimulus of CCK (sincalide).
After the gallbladder has filled during cholescintigraphy, gallbladder contraction is stimulated by an infusion of sincalide, 0.02 mcg/kg in 30 minutes. The amount of gallbladder emptying in 30 minutes reflects the gallbladder ejection fraction (GBEF), normal being greater than 35%. This protocol has demonstrated correlation of both normal and abnormal GBEF with surgical and medical follow-up.