Gallbladder Ejection Fraction and Sphincter of Oddi Dysfunction in Acute Idiopathic and Acute Recurrent Pancreatitis in Children

Abstract

Background and Aim: Gallbladder (GB) dysfunction leading to biliary sludge formation and sphincter of Oddi dysfunction (SOD) are the important causes of idiopathic acute pancreatitis (idiopathic AP) and acute recurrent pancreatitis (ARP) in adults. However, this is not investigated in children. We prospectively evaluation for gallbladder (GB) dysfunction and sphincter of Oddi dysfunction (SOD) in children with idiopathic and recurrent AP. Methods: All consecutive patients of idiopathic AP and ARP underwent 99mTc Mebrofenin Hepatobiliary Scintigraphy with intravenous tracer injection for 1 h. Subsequent premeal and postmeal static images following standard fatty meal administration were acquired up to 4 h for maximum gallbladder ejection fraction (GBEF) and hold up of radiotracer in the CBD. GBEF ≤ 35% is considered abnormal. Results: At total of 14 AP (male 50%) and 20 ARP (male 45%) patients underwent scintigraphy. Over all 11.7% (4 of 34) of the patients had poor GB contraction. The mean ± SD of GBEF in AP and ARP were 55.45 ± 24.05 and 56.10 ± 16.92 respectively. In AP and ARP groups, 21.4% (3 of 14) and 5% (1 of 20) had GB dysfunction (GBEF≤35%) respectively. There were no confirmed cases of sphincter of Oddi dysfunction (SOD). There was no stone or sludge in 4 patients with low GBEF. Conclusion: Among AP and ARP, 11.7% of patients had poor GB contraction. There was no sludge, microlithiasis or GB stone in patients with poor GBEF. The authors have none to declare.