Introduction : 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.