부산대학교 도서관

Aims: Although hepatobiliary scintigraphy has been widely used in patients with biliary pain, the histopathological factors of gallbladder that affect the findings of hepatobiliary scintigraphy is not fully known. The aim of the present study is to investigate the relationship between hepatobiliary scintigraphy findings and histopathological results in patients with recurrent biliary colic. Methods: A total of 107 patients who underwent hepatobiliary scintigraphy for recurrent biliary colic and subsequent cholecystectomy were retrospectively enrolled. According to the hepatobiliary scintigraphy findings, patients were categorized into three groups; patients with non-visualization of gallbladder activity (non-visualized GB group), gallbladder ejection fraction (GBEF) of <35% (low GBEF group), and GBEF of = 35% (normal GBEF group). Differences of histopathologic factors between three patient groups were evaluated and multivariate logistic regression analyses were performed to identify histopathological predictors for non-visualization of gallbladder activity and low GBEF. Results: Of all patients, 31 patients were classified as non-visualized GB group, 33 were low GBEF group, and 43 were normal GBEF group. Non-visualized group showed higher rates of patients with severe neutrophil, lymphoplasma cell, and eosinophil infiltrations and empyema and showed more increased cystic duct wall thickness than other groups (P<0.05). Low GBEF group showed higher muscle-to-total wall thickness ratio and muscle-to-fibrosis thickness ratio than those with normal GBEF group (P<0.05). On multivariate logistic regression analysis, Severe degrees of lymphoplasma cell infiltration (P=0.027) and eosinophil infiltration (P<0.001) were independent predictors for non-visualization gallbladder activity, and muscle-to-fibrosis thickness ratio (P=0.030) was an independent predictor for low GBEF. Conclusions: In patients with recurrent biliary colic, non-visualization of gallbladder activity on hepatobiliary scintigraphy was related with the degree of inflammation in the gallbladder, while GBEF was related with muscular hypertrophy of the gallbladder.