Oral Cholecystagogue Cholescintigraphy

Abstract

There is a need to establish high-quality normal GBEF range for a ubiquitous fatty meal (ie, a meal that would be widely available, easy to prepare, inexpensive, and free of sensitivity-provoking ingredients). A corn oil emulsion, has immense potential as an ideal FMC, limited currently only by its lack of established normal values. Currently, the highest-quality normal GBEF values available for FMC exist for 2 commercial products, Humana Infant Formula 1 and Ensure Plus. However, these products may not be readily available at some institutions, and neither one is free from dietary restrictions.

Use of a Fatty Meal Cholecystagogue Protocol in Hepatobiliary Scintigraphy for Chronic Functional Gallbladder Disease

“…Initial work on gallbladder contraction and biliary excretion resulted from cholegraphic studies in which patients were administered an oral cholecystagogue (22)(23)(24)(25). Examples of the reported oral cholecystagogues include milk, corn oil emulsion, Cholex (egg yolk, soya lecithin, glycerin, and peanut oil), D-sorbitol solution, safflower oil emulsion, vegetable oil, fatty meal (Lipomul), and Ensure Plus (5,8,12,22,23,(25)(26)(27)(28)(29)(30)(31)(32)(33). In 1957, cholecystokinin was developed as an intravenous cholecystagogue demonstrating prompt and strong contraction of the gallbladder and opening of the sphincter of Oddi (2,3).…”

“…Unfortunately, sincalide (the commercial analog of cholecystokinin) has been prone to shortages over the years; oral cholecystagogues have therefore been used to continue assessments for chronic functional gallbladder disorder (38). Among the oral cholecystagogues, milk, corn oil emulsions, Lipomul, and Ensure Plus have been investigated to assess for normal gallbladder ejection fractions (8,26,29,39). In adults, researchers found normal gallbladder ejection fractions to be at least 40% for milk after 60 min, at least 20% for corn oil emulsions after 60 min, and at least 33% for a fatty meal (i.e., Ensure Plus) after 60 min.…”