Background: The purpose of this study was to investigate the outcomes of patients with hyperkinetic gallbladders; that is, ejection fractions (EF) greater than 80% on HIDA scan.
Methods: We reviewed the charts of all patients presenting to St. John Hospital & Medical Center with biliary pain who had a HIDA scan with EF >80% from January 1, 2000 to May 1, 2013. Patients agreeing to participate were asked questions from a standardized script over the telephone. Demographics, presenting symptoms, pain (on presentation and currently) and surgery date and satisfaction, if conducted, were recorded.
Results: 67 patients participated. Mean EF was 88.6 ± 5.0%. Fifty-eight (86.6%) patients did not have surgery. In these patients the initial pain score, (10 point scale), was 7.1 ± 1.9 vs. 4.1 ± 3.2, p<0.0005, at the time of the questionnaire. Nine (13.4%) patients had surgery, their initial pain score was 7.1 ± 1.8 vs. 2.0 ± 2.6, p=0.001 after surgery. Four (44.4%) of these patients had stones. We were unable to find a significant difference in the drop of pain score between those who had surgery and those who did not (p=0.067).
Discussion: Over time, some resolution of pain symptoms occurred in both groups (no surgery vs. surgery). The surgical group had a greater resolution of
pain presented as a greater drop in pain score. The small number of patients who had surgery and the subjectivity of measuring pain scores limit our study.
The presence of stones in the surgical group may also raise the possibility of under diagnosis of this problem.
Conclusion: Hyperkinetic gallbladders deserve further studies to understand its association with biliary pain and whether surgery should be offered to
relieve this pain.