Clinical study on the effect of cholecystectomy on human bile excretion and function of sphincter of Oddi with quantitative hepatobiliary scintigraphy (QHBS)

Objective To study the effect of cholecystectomy on human bile excretion and the function of sphincter of Oddi.Methods Forty five volunteer patients of biliary disease were divided into three groups,i.e. control group (20 cases),postoperative group (15 cases),and group of delayed bile excretion (10 cases).After an overnight fasting intravenous bolus of 185 MBq of 99m Tc EHIDA was given to each patient and quantitative hepatobiliary scintigraphy (QHBS) was performed on patients before or after cholecystectomy.The same size regions of interest(ROI) over common hepatic duct, common bile duct,gallbladder and duodenum were taken respectively. The ratio of nuclide between the different ROIs at the real time was calculated and the distribution of nuclide at real time analyzed. Results By t test,the ratio of outflow to inflow through sphincter of Oddi and peak time in time activity curve of the region of interest over common bile duct had not changed statisticaly. SPECT can find the abnormal bile excretion in patients with normal B US result. Conclusions Excretion of bile and function of Oddi sphincter had no change before and after cholecystectomy in patients without obstruction of biliary tract,nor there was a postoperative compensatory dilatation of the common bile duct. Quantitative hepatobiliary scintigraphy (QHBS) proved to be a useful non invasive method in the diagnosis and differentiation of the type of sphincter of Oddi dysfunction(SOD).