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PubMed1985

Assessment of gallbladder function using ceruletide in oral cholecystography.

A dose of 0.3 micrograms/kg body weight of ceruletide was assessed for its effect on gallbladder contraction and bile duct delineation following oral cholecystography. Nausea, vomiting, and abdominal pain sometimes occurred after ceruletide. No relationship was found after ceruletide administration between the radiologic appearances of the biliary tract and reproduction of the patients' biliary-type symptoms. Ceruletide cholecystography is regarded as an inaccurate investigation of biliary tract function.

Adult↗
PubMed1977

Cholecystokinin cholecystography in the diagnosis of chronic acalculous cholecystitis and biliary dyskinesia. A cirtical appraisal.

Now that the active fragment of the cholecystokinin molecule has been made available for use in clinical pracitce, reports on the value of cholecystokinin cholecystography must be re-evaluated to determine if the procedure is worthwhile in patients with persistent symptoms and a normal conventional oral cholecystogram. Such an analysis discloses that there is no uniform agreement on what consitutes an abnormal examination and raises serious questions concerning the scientific validity of much of the data. It is apparent that there is no immutable evidence to date to indicate that cholecystokinin cholecystography is an accurate technique to determine which patients in this category will benefit from cholecystectomy.

Adolescent↗
PubMed1978

The development of cholecystography: the first fifty years.

Visualization of the gallbladder by x-ray was first achieved in 1923 by the intravenous introduction into the body of a halogenated compound which was excreted by the liver into the bile ducts and gallbladder [1--4]. This was the first time that visualization of an organ had been accomplished by introducing a substance into the body and obtaining a roentgenogram after the substance had been metabolized and localized primarily in one organ. Previously, visualization of an organ had been achieved only by introducing a substance opaque to the x-ray directly into the lumen and obtaining a roentgenogram to outline its inner wall. By 1925 visualization of the gallbladder had also been accomplished by the oral administration of halogenated compounds [5,6]. The drugs employed for intravenous and oral cholecystography had been synthesized specifically for that purpose based on earlier experimental work of other investigators. The following account describes in detail the experimental background of cholecystography, its origin, and its development and use during the ensuing fifty years.

Administration, Oral↗
PubMed1980

Tomography of the biliary tract during oral cholecystography: a review of 200 cases.

A review of 200 cases in which routine oral cholecystography was supplemented by tomography is presented. In 69 out of 82 non-visualised gallbladders (NVGB) definite confirmation of gallbladder apthology was obtained. In the poorly functioning gallbladder and the gallbladder obscured by bowel, further information was obtained in 32 out of 56 and 18 out of 26 cases respectively. Tomography proved helpful in localising small filling defects within the gallbladder. Tomography is unlikely to add any extra information to an oral cholecystogram in which a good after fatty meal (AFM) film has been obtained. It is concluded that tomography is a valuable addition to oral cholecystography and increases its accuracy.

Biliary Tract↗
PubMed1979

[Improvement of oral cholecystography and cholangiography with ceruletid (author's transl)].

Following oral cholecystography in 100 patients, the conventional "fatty meal" was replaced by an intramuscular injection of Ceruletid in a dose of 0.4 microgram/kg body weight. The synthetic decapetide Ceruletid is a substance with a hormone-like effect on the gastro-intestinal tract. It contracts smooth muscle in the gut and stimulates secretion in the stomach and the exocrine pancreas. Compared with other substances producing contraction which are given orally, Ceruletid acts more quickly and more powerfully in producing contraction of the gall bladder muscle. In 86% of positive cholecystograms, this resulted in satisfactory demonstration of the bile duct, 66% better than for oral substances. Many abnormalities, particularly localised adenomyomatosis, can only be diagnosed after good contraction of the gall bladder. Side effects, such as nausea, dizziness and a feeling of heat were transitory. In three patients it led to vomiting. The rapid and certain effect of Ceruletid during oral cholecystography requires reassessment of the role of intravenous cholangiography in diagnosis. Particularly amongst out-patients, with a high proportion of normal gall bladders, it is possible to complete the examination in one stage by demonstrating the bile duct with Ceruletid.

Bile Ducts↗
PubMedDate not supplied

Combined cholangiography and cholecystography using sodium iopanoate.

Cholangiography and cholecystography were performed in fasted dogs and human subjects using sodium iopanoate given intraduodenally in doses of 10 and 20 mg/kg. The same studies were performed after intraduodenal administration of fat or after intravenous administration of cholecystokinin (CCK) in dogs and after a fatty meal, to stimulate endogenous release of CCK, in human subjects. In both the animals and human subjects, peak blood iodine concentrations were reached by 30 minutes after iopanoate administration. At a dose of 10 mg/kg, radiographic visualization of both bile ducts and gallbladder was inconsistent. At 20 mg/kg (one-half the clinical dose for standard oral cholecystography,) the common bile duct was visualized within 60 minutes and the gallbladder within 90 minutes. Gallbladder density increased over the next 6 hours. Prior administration of fat or CCK led to earlier and denser gallbladder opacification. The common bile ducts opacified with the use of iopanoate were small in caliber, averaging only 3 mm. This probably reflects the fact that, unlike iodipamide, iopanoate has little or no choleretic effect. Therefore, because it would not increase the volume of bile in the duct, iopanoate would not increase duct size.

Adult↗
PubMedDate not supplied

Oral cholecystography in the early phase of acute alcoholic pancreatitis. A prospective, randomized comparison of Telepaque and Bilopaque.

Biliary tract disease is a major cause of acute pancreatitis. However, with traditionally employed Telepaque, radiographic visualization of the gallbladder during acute pancreatitis remains unreliable, even in patients with apparently normal gallbladders. Therefore, oral cholecystography has customarily been deferred for such patients for several weeks. Recently, successful oral cholecystography has been described during the acute episode of pancreatitis, using Bilopaque, a more water-soluble cholecystopaque. The relative intestinal absorption of Telepaque and Bilopaque and the ability of these agents to produce diagnostic oral cholecystograms of fasting patients with acute alcoholic pancreatitis were compared. Forty-five hospitalized patients were studied within 96 hours of admission. Mean peak plasma contrast concentrations for Bilopaque exceeded those for Telepaque. Thirty-one percent of the Bilopaque group achieved diagnostic single-dose oral cholecystograms, compared with to 11% of the Telepaque group (P less than 0.05).

Acute Disease↗
PubMed1991

Comparison of ultrasonography and oral cholecystography in biliary lithotripsy. I. Screening patients.

Ultrasound and oral cholecystography (OCG) are both used to evaluate candidates for biliary lithotripsy. Some investigators have suggested abandoning the OCG, believing that sufficient screening information can be obtained from ultrasound. This study compares ultrasound and OCG in assessing the size and number of gallstones, both in vitro and in vivo. In the in vitro model, 35 gallstones, divided into 20 groups, were separately suspended in dilute contrast media in a phantom, and examined by ultrasound and simulated OCG by each of three gastrointestinal radiologists. In the in vivo study, the ultrasound and OCG examinations from 53 patients were independently reviewed by three radiologists. The number and size of the stones were recorded in both studies. In the in vitro study, the stone size was measured within 2 mm of the actual size by OCG in 23/35 stones (66%) and by ultrasound in 4/35 stones (11%). The correct number of stones was determined by OCG in 19/20 groups (95%), and by ultrasound in 14/20 (70%). In the in vivo study, all readers saw the same number of stones in 40/50 (80%) patients by OCG and 33/49 (67%) patients by ultrasound. Statistical analyses revealed correlation coefficients for OCG greater than those for ultrasound in each comparison. The size of the largest stone was within 2 mm by all readers in 26/51 (51%) of patients by OCG and 20/47 (43%) patients by ultrasound. Oral cholecystography is more reliable than ultrasound for the determination of size and number of stones in patients being screened for biliary lithotripsy.

Adult↗
PubMed1985

Cholecystokinin cholecystography: is it a useful test?

We reviewed 57 patients, who during the last four years had cholecystokinin cholecystography during evaluation of abdominal pain, and found this test to be reliable for diagnosing chronic acalculous cholecystitis. Eighty-eight percent of the patients in whom abdominal pain was reproduced during cholecystokinin cholecystography and who had less than 50% contraction of the gallbladder were cured or improved after cholecystectomy.

Adult↗
PubMed1987

Gallstones: a comparison of real-time ultrasonography and cholecystography with surgical correlation.

Real-time ultrasonography is more accurate and technically more efficient than gray scale ultrasonography in establishing the diagnosis of cholecystolithiasis. In prospective studies accuracy may be as high as 96%, and reflects the use of specific sonographic diagnostic criteria. Retrospective studies, however, reveal a lower accuracy rate of 90%, suggesting that practicing radiologists are not ready to accept these restricting criteria. On the other hand, oral cholecystography (OCG) is well tolerated and gives a reproducible, reliable result independent of technical expertise. It is 96% accurate in detecting the presence of gallstones and carries a sensitivity of .97. Both studies are prone to overinterpretation, which skews specificity and adversely affects diagnostic accuracy. In this retrospective review of 234 consecutive cases of cholecystectomy, real-time ultrasound was 90% accurate with a sensitivity of .96 in determining the presence of cholecystolithiasis. Oral cholecystography was 95% accurate with a sensitivity of .97.

Administration, Oral↗
PubMed1976

Gray scale ultrasonic cholecystography: a comparison with conventional radiographic techniques.

A prospective study was designed to assess the accuracy of gray scale ultrasonography in the evaluation of cholelithiasis. A series of 111 patients with nonvisualization on first-day oral cholecystography underwent ultrasonic cholecystography, and the results were compared with subsequent second-day visualitzation or surgical findings. In 75 cases sufficient data were present to assess the accuracy of the method. Ultrasound correctly diagnosed 68 (91%) of these cases with regard to gallstones. Only 6 gallbladders could not be visualized ultrasonically and all subsequently proved to have gallstones. It is concluded that improved ultrasonic technique is of considerable value in investigating the nonvisualized gallbladder. Valuable information conderning other upper abdominal pathology was often discovered.

Cholecystography↗
PubMed1978

Single dose oral cholecystography.

The routine use of single dose oral cholecystography is suggested for the examination of outpatients. A diagnosis is more quickly obtained for the great majority of patients and there is a lower incidence of side effects. An effective method of contrast administration and filming is discussed. The medical, personal, and economic impact of single dose oral cholecystography is contrasted with that for routine consecutive dose examinations in an outpatient population.

Administration, Oral↗
PubMed1978

Prolonged gallbladder opacification after oral cholecystography.

Recent reports state that prolonged gallbladder opacification after an otherwise normal oral cholecystogram is abnormal and reliably indicates acalculous cholecystitis. In 122 patients on a variety of diets, the frequency with which prolonged gallbladder opacification is detectable one and two days after oral cholecystography was studied prospectively. Prolonged opacification was seen in 75% of patients and did not occur more commonly in those patients with documented gallbladder disease. Prolongation of gallbladder opacification after oral cholecystography is common and cannot be used as the sole criterion for the diagnosis of cholecystitis.

Adult↗
PubMed1979

The value of plain radiographs prior to oral cholecystography.

The diagnostic significance of a routine preliminary plain radiograph of the right upper abdominal quadrant prior to oral cholecystography was evaluated retrospectively. The plain radiograph was decisive in the diagnosis in only one case out of 1,022 consecutive cholecystographic examinations (0.1%) (95% confidence limits: 0.00-0.55%). The sensitivity of oral cholecystography, now approximately 90%, would drop by only 0.43% (95% confidence limits: 0.01-2.14%) if the routine plain radiograph were omitted.

Cholecystography↗
PubMed1980

The effect of diet and fasting on gallbladder opacification during oral cholecystography in dogs as measured by computed tomography.

To determine the influence of diet and fasting on gallbladder opacification during oral cholecystography, 10 dogs were studied in a blind, random fashion, giving single or two consecutive doses of iopanoic acid, sodium tyropanoate, or sodium ipodate while the animals were fasting, on a normal diet, or on a low-fat diet. Gallbladder density was determined by CT to eliminate the bias created by subjective interpretation of radiographs. For maximum, first-dose gallbladder opacification during clinical cholecystography, iopanoic acid should be given with a meal and sodium ipodate while the patient is fasting; diet makes no difference with sodium tyropanoate. For maximum opacification with two consecutive doses, iopanoic acid may be given with a meal or during fasting, while sodium ipodate and sodium tyropanoate should be administered during fasting.

Administration, Oral↗
PubMed1981

Single-visit oral cholecystography for inpatients.

A new one-day medication schedule for single-visit oral cholecystography is described, using both Telepaque (iopanoic acid) tablets and Oragrafin Sodium (sodium ipodate) capsules. A definitive report is rendered at the first sitting; no repeat studies are performed. Preliminary results in 45 patients demonstrate the accuracy of this technique. One-day medication makes single-visit oral cholecystography suitable for hospitalized patients.

Cholecystography↗
PubMed1990

Gallstone composition in relation to buoyancy at oral cholecystography.

Although it is recognized that some gallstones float at oral cholecystography, the reasons for this are not known. To determine how stone type and composition are related to stone buoyancy, the authors analyzed gallstones from 90 patients in the National Cooperative Gallstone Study. Seventeen patients had floating and 73 had nonfloating radiolucent stones at oral cholecystography. Stone analysis showed that all 17 floating stones were cholesterol stones; 64 of the nonfloating stones were cholesterol stones, while nine were pigment stones. The cholesterol contents of floating and nonfloating cholesterol stones were similar, 90.4% +/- 1.7 and 87.0% +/- 1.2 of stone weight, respectively. The calcium salt content of the nonfloating cholesterol stones was 3.2% +/- 0.6, while that of the floating cholesterol stones was only 1.1% +/- 0.4 (P = .02). The results indicate that floating gallstones are cholesterol stones with a significantly lower calcium salt content than that of nonfloating cholesterol stones.

Cholecystography↗
PubMed1975

A new contrast medium for cholangio-cholecystography: meglumine iodoxamete.

A preliminary study of 18 patients following a single bolus intravenous injection of 10 to 30 cc. of meglumine iodoxamate (Cholovue), a new contrast medium for cholangio-cholecystography, showed no significant adverse clinical or laboratory effects with 10 to 20 cc., and only transient, minor changes with 30 cc. Early and persistent visucalization of the subsegmented and major bile ducts and the gallbladder was obtained. Good to excellent opacification was obtained in all cases with doses ranging between 0.11 cc./kg. (19.7 mg. iodine) to 0.59 cc./kg. (108 mg. iodine). Meglumine iodoxamate appears to be highly effective agent for cholangio-cholecystography.

Adolescent↗