To evaluate the application value of radionuclide hepatobiliary imaging and ultrasonography in patients undergoing gallbladder-preserving surgery.

Clinical data of 40 patients with cholecystolithiasis who underwent laparoscopic and rigid choledochoscopic cholelithotomy in the Second Affiliated Hospital of Air Force Medical University from June to December 2017 were retrospectively analyzed. Among them, 16 patients were male and 24 female, aged(42±13) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. All the patients received ^99mTc-EHIDA radionuclide hepatobiliary imaging and abdominal ultrasound to evaluate the contractile function of gallbladder. According to the ultrasound results, patients with gallbladder contraction rate between 30% and 60% were assigned into group A (n=30) and those with gallbladder contraction rate >60% were allocated into group B (n=10). The gallbladder ejection fraction (GBEF) measured by radionuclide hepatobiliary imaging were compared by t test betweentwo groups. The correlation between two detections was analyzed by linear correlation analysis. The success of gallbladder-preserving surgery was considered as the gold standard for diagnosis. The diagnostic efficiency of two methods were statistically compared by the ROC curve.

33 patients underwent gallbladder-preserving cholelithotomy successfully, including 24 cases in group A and 9 cases in group B. GBEF was (32±19)% in group A and (61±11)% in group B, where significant difference was observed (t=2.200, P<0.05). The gallbladder contraction rate was positively correlated with GBEF (r=0.070, P<0.05). The area under ROC curve (AUC) of diagnosis by GBEF was 0.952, the specificity was 0.88, the sensitivity was 1.00, and the accuracy rate was 90%. The AUC of diagnosis by gallbladder contraction rate was 0.721, the specificity was 0.55, the sensitivity was 0.88, and the accuracy rate was 60%. Significant difference was noted between two AUCs (Z=3.299, P<0.05). During the 24-month follow-up, no recurrence of gallbladder stones occurred in group A and 1 case of recurrence was reported in group B at postoperative 20 months.

Radionuclide hepatobiliary imaging can better evaluate the contractile function of gallbladder as well as the patency of biliary tract. Ultrasound examination is more reliable when the biliary tract is occluded. Radionuclide hepatobiliary imaging combined with ultrasound examination can provide more reliable reference for gallbladder-preserving cholelithotomy in patients with cholecystolithiasis.