"LAZY GALLBLADDER" (FUNCTIONAL GALLBLADDER DISORDER): NA INTEGRATIVE REVIEW OF DIAGNOSIS, THE ROLE OF CHOLESCINTIGRAPHY AND OUTCOMES OF CHOLECYSTECTOMY

Abstract

This article aimed to synthesize the evidence on diagnosis, the role of cholescintigraphy and the outcomes of cholecystectomy in functional gallbladder disorder, popularly known as "lazy gallbladder" and defined by the Rome IV criteria as biliary pain without gallstones or other structural abnormality. This is an integrative review with searches in PubMed, LILACS and SciELO in November 2026, restricted to publications from 2006 to 2026. Of the 327 records identified, 303 were screened, 104 had their abstracts assessed and 30 were included: eight systematic reviews, one pilot randomized trial, two consensus documents, four epidemiological studies and 15 cohorts. A reduced ejection fraction was associated with a higher chance of improvement with surgery than with medical treatment, but discriminated poorly between patients who did and did not improve after cholecystectomy, and the type of stimulus changed test results. Improvement rates after surgery ranged from 43% to 93%, including inincluding in gallbladders with normal or high ejection fraction. Surgical indication should rest gallbladders with normal or high ejection fraction. Surgical indication should rest mainly on amainly on a typical clinical picture, with cholescintigraphy as a complementary test, and typical clinical picture, with cholescintigraphy as a complementary test, and controlled trials arecontrolled trials are lacking. lacking.