Delayed biliary-to-bowel transit in cholescintigraphy after cholecystokinin pretreatment and its postulated mechanism

The authors have assessed the influence of cholecystokinin (CCK) pretreatment on biliary-to-bowel transit (BBT) of Tc-99m amino-diacetic acid (IDA) during cholescintigraphy. Fourteen volunteers underwent cholescintigraphy with and without CCK administration. Following IDA injection, images were obtained for 2 hours. In all 14 subjects, the BBT time was less than 1 hour without CCK. With CCK no bowel activity had occurred by 2 hours in seven of 14 subjects (50%) (P = .006). The authors have also analyzed 83 cholescintigrams (50 with and 33 without CCK) of patients suspected to have acute cholecystitis. Of the 50 obtained with CCK, the BBT time was less than 30 minutes in all 10 patients without gallbladder filling and two with gallbladder filling after 1 hour or longer, while 14 or 29 patients (48%) with gallbladder filling in less than 1 hour had a BBT time of 1 hour or longer (P much-lt .001). In 32 of the 33 scans obtained without CCK, the BBT time was less than 1 hour