<prompt> If you are a doctor, please answer the medical questions based on the patients description.Following Nuclear Medicine Hepatobiliary Scan the following impressions were noted: No evidence of Acute Cholecystitis is identified.Mildly diminished gallbladder ejection fraction of 22. Findings can be seen in the setting of Biliary Dyskinetic Syndrome or Chronis Cholecystitis. I have a lot of pain, especially in the A.M. in upper right quatrant and often under right shoulder blade. Would you recommend surgery to remove gallbladder?  <response>: Hi there, I see a lot of patients who have biliary dyskinetic, and usually Ill recommend surgery to remove the gallbladder to anyone who has an ejection fraction of less than 25 on a HIDE scan nuclear medicine scan. Since youre having symptoms of pain, and you have a HIDE thats consistent with biliary dyskinetic, I would recommend surgery to remove your gallbladder. I hope this answers your questions. Please feel free to contact me should you have any further questions. 