78226 Hepatobiliary system imaging, including gallbladder when present

Name of the Procedure:

Hepatobiliary system imaging (Hepatobiliary scan, HIDA scan, Cholescintigraphy)

Summary

Hepatobiliary system imaging is a diagnostic procedure that involves scanning the liver, bile ducts, gallbladder, and small intestine. It uses a radioactive tracer to create images and assess the function of these organs.

Purpose

The procedure helps in diagnosing conditions of the hepatobiliary system, such as gallbladder disease, bile duct obstructions, and liver dysfunction. The goal is to identify issues with bile production and flow and to find any abnormalities in the gallbladder when present.

Indications

• Symptoms such as abdominal pain, jaundice, and unexplained fever.
• Suspected gallbladder issues like gallstones or cholecystitis.
• Evaluation of bile duct obstructions or bile leaks.
• Assessment of liver transplant function.

Preparation

• Patients may be required to fast for 4-6 hours before the procedure.
• Any recent imaging studies should be shared with the healthcare provider.
• Certain medications might need to be adjusted or stopped temporarily.

Procedure Description

1. The patient is positioned on an examination table.
2. A small amount of radioactive tracer is injected into a vein.
3. The patient lies still as a gamma camera takes images over usually 1-2 hours.
4. The camera tracks the flow of the tracer through the liver, bile ducts, gallbladder, and small intestine.

No anesthesia is required, and the procedure is non-invasive.

Duration

The procedure typically takes 1-2 hours.

Setting

It is performed in a hospital’s nuclear medicine department or an outpatient imaging center.

Personnel

• Nuclear medicine physician or radiologist
• Nuclear medicine technologist
• Nurses for patient support

Risks and Complications

• Slight risk of allergic reaction to the tracer.
• Rare possibility of infection or bruising at injection site.
• Low-level radiation exposure, generally considered safe.

Benefits

• Provides detailed images of the hepatobiliary system.
• Aids in accurate diagnosis of liver and gallbladder conditions.
• Non-invasive with minimal patient discomfort. Results are usually available within a few days.

Recovery

• Most patients can resume normal activities immediately after the procedure.
• Drink plenty of fluids to help flush the tracer from the body.
• Follow-up appointment may be scheduled to discuss results.

Alternatives

• Ultrasound imaging
• CT scan
• MRI with or without MRCP
• Each alternative has its own advantages, like no radiation with ultrasound but may not provide as detailed imaging as a HIDA scan.

Patient Experience

• Patients may feel a slight sting from the injection.
• Lying still may cause minor discomfort.
• Pain management and comfort measures are typically not necessary due to the non-invasive nature of the procedure.