4685 Comparison of egd with biliary drainage and cholesterol crystal analysis to cck-hida scan in the diagnosis of acalculous biliary colic.

Abstract

INTRODUCTION: Biliary colic with documented gallstones is a frequently encountered problem. Treatment with cholecystectomy has been shown to be safe and effective especially in this era of laparoscopy. However, a variant of this disease is acalculous biliary colic without acute cholecystitis. Many have hypothesized that this may be due to gallbladder dysmotility and resultant biliary sludge. Current data does not provide a definitive work-up or treatment plan for this disease.AIM:To determine if an EGD with biliary drainage and cholesterol crystal analysis (CCA) is as effective as a CCK-HIDA scan in determining the etiology of acalculous right upper quadrant abdominal pain. METHOD: Retrospective review of patients presenting with typical biliary colic (post-prandial abdominal pain +/- nausea and vomiting) from January 1 through September 30, 1999. All patients had a normal abdominal ultrasound and normal laboratory evaluation. All patients then underwent an EGD with CCA and a CCK-HIDA scan for gallbladder ejection fraction (GBEF). All patients had no significant gastroduodenal disease on endoscopy and symptoms were refractory to acid suppression with proton pump inhibitors. Patients with either a GB-EF