Biliary imaging and excretory dynamics after papillotomy in patients with an intact gallbladder

After endoscopic papillotomy, patients with intact gallbladders have remained at risk for acute cholecystitis (AC). Sphincter ablation might impair gallbladder filling on cholescintigraphy (nonvisualization) and thus result in false-positive tests for AC. The authors studied six asymptomatic postpapillotomy volunteers with intact gallbladders. The authors used quantitative cholescintigraphy for gallbladder visualization and US, abdominal radiography, and barium-swallow examination to detect biliary air and duodemo-biliary reflux. Gallbladder nonvisualization by scintigram occurred in three subjects (50% false-positive rate). Cholescintigraphic results did not correlate with other radiologic findings. Thus, baseline cholescintigrams might identify postpapillotomy patients in whom scintigraphy would be useful in the diagnosis of AC