@entity490 is a commonly encountered clinical problem whose pathophysiology is unclear and evaluation and management are controversial. Cholecystokinin cholescintigraphy to measure the gallbladder ejection fraction (GEF) has been advocated as a criterion for cholecystectomy. However, there is no consensus regarding the dose and rate of infusion of @entity8586 , both of which can alter the GEF, and the definition of an abnormal ejection fraction varies among studies. Many but not all studies have concluded that a low GEF predicts good outcomes after cholecystectomy, but most studies suffer from poor methodology and there is only one prospective randomized controlled trial. Also, some @entity1 with a normal GEF have responded to cholecystectomy. Another controversial area has been the role of @entity1690 ( @entity1690 ) in @entity1 with biliary-type @entity158 and gallbladder in situ. Some reports suggest an overlap between @entity1690 and low GEF, although a causal relationship has not been established. Yet another subject of interest is the role of @entity1931 in @entity1 with @entity158 . We have reviewed the relevant literature relating to these issues and have highlighted the controversial aspects. In the absence of high-quality studies, an evidence-based treatment algorithm is difficult to design but will be proposed. More prospective controlled trials are warranted to better define the appropriate evaluation and management of @entity1 with this syndrome.

Controversies concerning pathophysiology and management of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1690 :: ('MESH:D046628', 'Disease') :: ['sphincter of Oddi dysfunction', 'SOD'] @entity1931 :: ('MESH:D006930', 'Disease') :: ['visceral hyperalgesia'] @entity8586 :: ('MESH:D002766', 'Chemical') :: ['cholecystokinin'] @entity158 :: ('MESH:D010146', 'Disease') :: ['acalculous biliary-type pain', 'pain'] @entity490 :: ('MESH:D015746', 'Disease') :: ['Acalculous biliary-type abdominal pain']
@entity490 :: (MESH:D015746,Disease) :: ['acalculous biliary-type abdominal pain']
