ABSTRACT
In this study, 46 patients [36 females and 10 males] presenting with variable degrees of long-standing upper right quadrant abdominal pain were included. All patients underwent clinical evaluation, abdominal ultrasonography and Tc99m hepatic iminodiacetic acid [HIDA] scanning with gallbladder ejection fraction [GBEF] calculation. Clinically, 26 patients had a mild degree of biliary pain, while 20 patients had a moderate degree. Ultrasonography was free in 26 patients, while 20 patients showed an evidence of GB abnormalities ranging from mild to severe changes. A confirmatory test was used in these cases by adding the sonographic and clinical findings for each patient to aid in the decision to operate or not. HIDA scanning was carried out in all patients with GBEF calculation. A 35% value was taken as a cutoff measurement, where patients with values <35% were considered abnormal and positive for acalculous GB disease. In patients with a proper GBEF [>35%], no operation was done and they were placed on the follow up and represent [18 patients]; while patients with abnormal GBEF [<35%], even with a negative confirmatory test, were operated by cholecystectomy [28 patients]. The mean GBEF value in the non- operated group was 55.9%, while that of the operated patients was 23.3%. All the operated patients proved positive to histopathology for acalculous cholecystitis. A remarkably highly positive P-value was found between the operated and non-operated groups as regards the GBEF value