Biliary scintigraphy in acute pancreatitis.

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Abstract
A prospective study was carried out in 60 patients to determine the efficacy of 99mTc-PIPIDA (p-isopropyliminodiacetic acid) scintigraphy in differentiating biliary pancreatitis from nonbiliary pancreatitis. Patients (40) were classified as having biliary pancreatitis and 20 patients as having the nonbiliary type. Scintigraphic scans were divided into 5 main types according to the time of visualization of the gallbladder and the time of excretion of 99mTc-PIPIDA into the intestinal tract. Normal scans were obtained in 95% of patients (19/20) with nonbiliary pancreatitis; 22.5% of patients (9/40) with biliary pancreatitis had normal scans. Elevated amylase levels together with an abnormal biliary scan, as defined by the criteria presented here, indicate biliary pancreatitis, while a normal scan largely excludes such diagnosis.