Evaluation of treatment method for choledocholithiasis by cholescintigraphy

We performed 99mTc-PMT cholescintigraphy on 30 patients with cholelithiasis and 27 patients with choledocholithiasis, evaluated bile duct function by measuring extrahepatic bile duct transit time, which is duodenal visualization time minus porta-hepatis bile duct visualization time, to compare various treatment methods for choledocholithiasis. Also, we compared the diameters of the bile ducts before and after surgery to examine the effects of choledocholithotomy. The mean extrahepatic bile duct transit time in the cholelithiasis group was 4 min 28 sec±2 min 28 sec, whereas that in the choledocholithiasis group was significantly longer at 7 mm 42 sec±5 mm 16 sec (p<0.01). By techniques, the endoscopic transpapillary choledocholithotomy group (16 patients) had a mean extrahepatic bile duct transit time of 6 min 30 sec±5 min 16 sec, which was not significantly different from that in the cholelithiasis group. In contrast, the papilla-preserving group (11 patients) had a significantly long mean extrahepatic bile duct transit time of 9 min 27 sec±4 min 46 sec (p<0.01). In this study, bile duct function became normalized after endoscopic transpapillary choledocholithotomy, and bile duct dilatation decreased after surgery, suggesting long-term normalization of bile duct function. (author)