CCK-induced gall bladder hyperkinesia: An indication for cholecystectomy and brain-GI connectivity research

Abstract

1312 Objectives Cholecystokinin (CCK) heptobiliary scans are used to evaluate patients with suspected biliary dyskinesia(BD) presenting with abdominal pain.These patients often have co-morbid anxiety leading to the evaluation of both digestive and psychiatric disease.Ejection fractions(EF) 80% has not been reported. Methods A questionnaire was obtained from the PCP of 108 consecutive patients with HGBEF asking a)presenting symptoms b)if cholecystectomy (CS) was performed and, if so c)whether the symptoms showed no improvement, partial resolution or complete resolution of symptoms. Sixty-three patients were evaluated with complete data. Results Twenty-eight of 63 (44%) HGBEF patients had CS.Twenty-seven of 28(97%)showed symptomatic improvement following CS.Twenty-two of 28(79%)had complete resolution.One was non-responsive. Some patients reported continued anxiety symptoms. Conclusions Patients with HGBEF respond favorably to CS.The reason may be related to excessive contractility and associated with anxiety.We speculate that this commonly observed co-existence may be secondary to parallel disturbances in peripheral and central cholecystokinergic-neuromodulatory system.Future work will determine if the CCK-augmented scan will be a novel nuclear medicine tool in the investigation of the cholecystokinergic system in co-morbid anxiety-GI syndromes.