Efficacy of cholecystectomy in patients with positive HIDA Scans with typical or atypical biliary pain: A retrospective study

Dr Amin Tanveer MD, MSc1*(Sydney), Dr David Soon MBBS, MSc1(Edinburgh), Dr Rajavel Senthikumar Sundaramurthy MBBS, FRACS2, Dr Charles Pilgrim MBBS FRACS, PhD3, Dr Peter Evans MBBS, FRACS3

 1,2,3Department of General Surgery, Peninsula Health, PO Box 52, Frankston, 3199, Victoria, Australia

Introduction: Our investigation aimed to discover the benefits of performing cholecystectomy in patients who had a positive or negative HIDA scan result, presented with either typical or atypical biliary pain.

Methods: We performed a retrospective analysis of medical records of patients who had a HIDA scan at Peninsula Health between 2012 and 2017, those who had a HIDA scan and cholecystectomy for biliary pain were selected for this study, and prospective analysis of patient reported outcome post cholecystectomy included.

Results: In the past five years, 190 patients had had a HIDA scan to investigate biliary pain without a structural cause. Of those 190, 65 had a positive HIDA result and 20 of these patients went on to have a cholecystectomy. Of the latter, 17 who reported typical biliary pain had their pain resolved post-surgery but 2 out of 3 patients with atypical biliary pain had ongoing pain despite surgery (1 did not respond). Of the 125 patients with a negative HIDA scan, 14 proceeded with a cholecystectomy. Twelve patients had pre-operative typical biliary pain and 5 of these continued to have pain post-operatively. Finally, 1 of the 2 patients with atypical pain continued to have ongoing pain post-surgery.

Conclusion: In summary, in patients without a structural cause for biliary pain HIDA scans and patient’s symptoms greatly aid in the decision-making process whether to proceed with a cholecystectomy, as a negative scan should prompt further clinical investigation before proceeding with surgery.

Keywords: Hepatobiliary Imino Diacetic acid (HIDA) scans; Cholescintigraphy, Dysfunctional gallbladder, Cholecystectomy

Free Full-text PDF

How to cite this article:

Amin Tanveer, David Soon, Rajavel Senthikumar Sundaramurthy,Charles Pilgrim, Peter Evans. Efficacy of cholecystectomy in patients with positive HIDA Scans with typical or atypical biliary pain: A retrospective study. American Journal of Surgical Research and Reviews, 2021; 4;13. DOI:10.28933/ajsrr-2021-01-1705


1. Croteau DI. Speed your diagnosis of this gallbladder disorder. J Fam Pract. 2013;62(1):4-8.
2. Sorenson MK, Fancher S, Lang NP, Eidt JF, Broadwater JR. Abnormal gallbladder nuclear ejection fraction predicts success of cholecy- stectomy in patients with biliary dyskinesia. Am J Surg. 1993;166(6):672-4; discussion 4-5.
3. Riyad K, Chalmers CR, Aldouri A, Fraser S, Menon K, Robinson PJ, et al. The role of (99m)technetium-labelled hepato imino diacetic acid (HIDA) scan in the management of biliary pain. HPB : the official journal of the International Hepato Pancreato Biliary Association. 2007; 9(3):219-24.
4. DuCoin C, Faber R, Ilagan M, et al. Normokinetic biliary dyskinesia: a novel diagnosis. Surg Endosc. 2012;26:3088e3093.
5. Al-Azzawi HH, Nakeeb A, Saxena A, Maluccio MA, Pitt HA. Chole¬cystosteatosis: an explanation for increased cholecystectomy rates. J Gastrointest Surg. 2007;11(7):835-842.
6. Bingener J, Richards ML, Schwesinger WH, Sirinek KR. Laparoscopic cholecystectomy for biliary dyskinesia: correlation of preoperative cholecystokinin cholescintigraphy results with postoperative outcome. Surg Endosc. 2004;18: 802e806.
7. Morris-Stiff G, Falk G, Kraynak L. The cholecystokinin provocation HIDA test: recreation of symptoms is superior to ejection fraction in predicting mediumterm outcomes. J Gastrointest Surg. 2011;15e2:345e349.
8. Reed Jr DN, Fernandez M, Hicks RD. Kinevac-assisted cholescintigraphy as an accurate predi- ctor of chronic acalculous gallbladder disease and the likelihood of symptom relief with cholecystectomy. Am Surg. 1993;59:273e277.
9. Ponsky TA, DeSagun R, Brody F. Surgical therapy for biliary dyskinesia: a metaanalysis and review of the literature. J Laparoendosc Adv Surg Tech A. 2005;15: 439e442
10. Richmond BK. Optimum Utilization of Cholecy- stokinin Cholescintigraphy (CCK-HIDA) in Clini- cal Practice: An Evidence Based Review. West Virginia Medical Journal. 2012 Mar;108:8-11.

Terms of Use/Privacy Policy/ Disclaimer/ Other Policies:
You agree that by using our site, you have read, understood, and agreed to be bound by all of our terms of use/privacy policy/ disclaimer/ other policies (click here for details).

This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.