78227 Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed

Name of the Procedure:

Hepatobiliary System Imaging with Pharmacologic Intervention, including Gallbladder and Quantitative Measurements
(Common name: HIDA scan with pharmacologic intervention)

Summary

This procedure involves imaging the liver, bile ducts, gallbladder, and small intestine using a special radioactive tracer to assess their function and structure. Pharmacologic agents are used to stimulate or inhibit certain actions within the hepatobiliary system, aiding in the quantitative analysis of the organs' performance.

Purpose

The primary aim is to diagnose and evaluate conditions affecting the liver, bile ducts, gallbladder, and small intestine. It helps in identifying blockages, infections, gallbladder function, and bile leaks. The expected outcome is a detailed visualization and functional assessment of the hepatobiliary system to guide appropriate treatment.

Indications

• Unexplained upper abdominal pain
• Suspected gallbladder disease or dysfunction
• Suspected bile duct obstruction or leak
• Post-surgical evaluation of the hepatobiliary tract
• Symptoms of jaundice or abnormal liver function tests

Preparation

• Patients are usually instructed to fast for 4-6 hours before the procedure.
• Certain medications may need to be paused or adjusted.
• A preliminary blood test may be required to check liver function.

Procedure Description

1. The patient receives an intravenous injection of a radioactive tracer.
2. Imaging equipment captures the movement and uptake of the tracer through the hepatobiliary system.
3. Pharmacologic agents (e.g., cholecystokinin) may be administered to stimulate gallbladder contraction or emptying.
4. Sequential images are taken over several hours to assess the dynamic function and structure of the hepatobiliary system.
5. Quantitative measurements are recorded to analyze the function of the gallbladder and bile ducts.

Duration

The entire process typically takes between 1-4 hours, depending on the specifics of the examination.

Setting

This procedure is performed in a hospital's nuclear medicine department or an outpatient imaging center.

Personnel

• Nuclear medicine technologist
• Radiologist or nuclear medicine physician
• Nursing staff
• Pharmacologist (where applicable)

Risks and Complications

• Allergic reaction to the radioactive tracer or pharmacologic agent (rare)
• Nausea or abdominal discomfort
• Radiation exposure (minimal and generally considered safe)

Benefits

• Accurate diagnosis and assessment of hepatobiliary system disorders
• Non-invasive and relatively safe procedure
• Can guide and improve the effectiveness of subsequent treatments

Recovery

• Minimal recovery time; most patients can resume normal activities immediately.
• Patients are advised to drink plenty of fluids to help flush the tracer from their system.
• Follow-up appointments may be scheduled to discuss results.

Alternatives

• Ultrasound imaging
• CT or MRI scans
• Endoscopic retrograde cholangiopancreatography (ERCP) Pros and cons of alternatives depend on specific patient needs and diagnostic goals.

Patient Experience

• The patient may feel a slight sting from the tracer injection.
• Lying still for extended periods may cause discomfort.
• Some patients might experience mild abdominal cramping with pharmacologic agents.
• Pain management and comfort measures are provided as needed.