SEARCH · PubMed Health

Results for “CHOLECYSTOGRAPHY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources

PubMed1977

The usefulness of stool screening for diagnosing cholelithiasis in acute pancreatitis. A description of the technique.

Screening stools for gallstones in patients with acute pancreatitis has been found to be a valuable diagnostic procedure in clinical practice. It is particularly helpful to know that a patient with pancreatitis has gallstones and, therefore, the disease is probably caused by the passage of these stones. A detailed description of the technique employed for stool screening is presented. The procedure was applied in 51 patients recovering from an attack of gallstone pancreatitis,in 51 control patients with known gallstones disease but without acute pancreatitis, and also in 10 patients with acute alcoholic pancreatitis Gallstones were found in the feces in 47 of the 51 patients with gallstone pancreatitis (92.1%), in only 6 of the 51 control cases (11.8%) (chi square = 62.84; P less than 0.0001), and in none of the 10 patients with alcoholic pancreatitis. In the group with gallstone pancreatitis, the finding occurred within 10 days after the attack. Oral cholecystography was also accomplished an average of 12.7 days after the attack in 38 of the 61 pancreatitis patients (28 with biliary and 10 with alcoholic pancreatitis). In 27 of the 28 patients with gallstone pancreatitis (96.4%) and in 4 of the 10 patients with alcoholic pancreatitis, radiologic evidence of cholelithiasis was found. There were 19 patients with gallstone pancreatitis who did not have a cholecystogram accomplished because of jaundice, recurrent pancreatitis, previous cholecystectomy, and pregnancy. These results suggest that screening stools is as accurate and reliable as cholecystography for the diagnosis of gallstones in individuals with pancreatitis. In addition, this method has three definite advantages over cholecystography: There are no contraindications; it requires no special equipment or personnel; and it can be used much earlier than cholecystography in patients recovering from an attack of acute pancreatitis. Screening stools for gallstones should be considered an elective diagnostic procedure for current clinical application.

Acute Disease↗

PubMed1978

Ultrasound and false normal oral cholecystogram.

Although oral cholecystography is a highly accurate investigation for the diagnosis of gallbladder disease, false normal examinations do occur. In other patients, the presence of jaundice, nausea, or vomiting may preclude oral cholecystography. When there is clinical suspicion of gallbladder disease with a normal or equivocal oral cholecystogram, ultrasound examination is a highly accurate alternative imaging procedure. We describe in this article three patients with apparently normal oral cholecystography who were found to have obvious gallstones on ultrasound examination and at surgery. The relative accuracy of these diagnostic procedures is reviewed and their place in the diagnosis of biliary tract disease is discussed.

Administration, Oral↗

PubMed1995

Sensitivity of percutaneous endoscopy compared with ultrasonography in the detection of residue or mucosal lesions after topical gallbladder stone dissolution.

BACKGROUND: Early gallstone recurrence in some patients after "successful" percutaneous topical dissolution may be due to residual debris. An endoscope small enough to be introduced without dilating the existing percutaneous track was used for gallbladder examination after stone dissolution. METHODS: The sensitivity of gallbladder endoscopy was compared with ultrasonography and double-contrast cholecystography for the detection of residual debris or mucosal lesions in 18 patients who underwent percutaneous topical dissolution. All examinations were performed before catheter removal and after the gallbladder was deemed stone-free by the traditionally employed technique of single-contrast cholecystography. RESULTS: Residual debris was detected in only one patient by ultrasonography and in none of the 18 patients by double-contrast cholecystography, yet endoscopy showed stone fragments ranging from 1 to 3 mm in 13 of the 18 patients. In all these patients, catheter repositioning and additional solvent perfusion resulted in elimination of the debris as assessed endoscopically. Two patients had endoscopically detected erosions. Double-contrast fluoroscopy found only one of these, whereas ultrasonography detected neither. CONCLUSIONS: Percutaneous gallbladder endoscopy is a more sensitive imaging modality for the detection of residual stone debris or mucosal lesions after gallstone dissolution.

Cholecystography↗

PubMed2002

Functional analysis of gallbladder using three-dimensional ultrasound: preliminary results.

In evaluating gallbladder function, the clinical feasibility of three-dimensional (3-D) ultrasound (US) using volumetric acquisition was assessed in 30 patients: 18 patients with gallstones and 12 healthy volunteers. 3-D ultrasonography was performed in each patient before and after a fat-meal test. The ejection fraction of the gallbladder from two volumes measured by computer-aided analysis was calculated. There were significant differences in the gallbladder ejection fractions among the diseased and control groups (p < 0.0001). Compared with the results of oral cholecystograms, the ejection fraction of the gallbladder using 3-D volumetry and the grade of oral cholecystography showed good correlation in predicting the gallbladder dysfunction (gamma = 0.71, p = 0.002). Even in cases failing oral cholecystography, the gallbladder ejection fraction using 3-D US was calculated without any difficulty. Conclusively, volumetric acquisition of 3-D US enables us to evaluate gallbladder function and provides a reliable diagnostic yield superior to oral cholecystography.

Adult↗

PubMed1995

[Radiological diagnosis before and after laparoscopic cholecystectomies].

PURPOSE: To study the diagnostic value of radiological imaging modalities in patients undergoing endoscopic cholecystectomy. PATIENTS AND METHODS: In 286 patients with endoscopic cholecystectomy ultrasound and intravenous cholecystography was performed for preoperative work-up. Postoperatively all patients were examined with ultrasound. RESULTS: ERCP showed a stone in the common bile duct in 12 patients with suspected stones on ultrasound, cholecystography or laboratory values. All 12 patients were treated with papillotomy. Postoperative ultrasound detected increasing fluid in the peritoneal cavity in three patients. Laparotomy of one patient showed bleeding from the cystic artery, in the second patient, injury of the right bile duct. One patient showed an accessory hepatic duct, another patient demonstrated pancreatitis. CONCLUSION: Ultrasound and intravenous cholecystography are suitable for preoperative imaging. Postoperative ultrasound is useful in detecting complications.

Adult↗

PubMedDate not supplied

Factors in the intestinal absorption of oral cholecystopaques.

Interest in the pharmacokinetics of cholecystopaques initially centered on transport from blood to bile. The data obtained in this effort have been valuable and have shown that the maximal iodine concentration achievable in the bile is quite similar for all of the currently available compounds. This concentration is, of course, dose dependent. the transport of contrast material from the bowel to the blood has been shown to be quite variable. Considerable progress was made in understanding this. The tremendous differences in absorption of iopanoic acid depending upon the pH of the administered solution was an initial revelation. The development of the concept that there is a water layer through which the cholecystopaque must pass before reaching the lipid membrane of the intestinal cell has added clarity to understanding the difference in absorption between water-soluble and water-insoluble cholecystopaques. A complete knowledge of what might enhance or inhibit absorption is not known. There is beginning to be an understanding of how intestinal dose relates to plasma levels. This should lead to an optimal dose-timing scheme for each cholecystopaque. The basic assumption is that the highest iodine concentration in the gallbladder leads to the most accurate cholecystography. If this is true, the gallbladder needs to be offered bile at the maximum concentrations during the period preceding filming. To accomplish this, the appropriate plasma level necessary for maximum excretion is needed. Experimental data suggest that our current clinical methods in regard to dose and dose timing need revision to optimize cholecystography. This revision needs to take place with a careful look at toxicity. Accepting the present premise that oral cholecystography can be improved, perhaps without a significant increase in morbidity, a fundamental question to be asked is: is it worth it?

Animals↗

PubMed1976

Changes of circulating thyroxine, triiodothyronine and reverse triiodothyronine after radiographic contrast agents.

Thyroid function was studied for 42 days in 58 patients, 28 of whome had euthyroid goiter, after urography (diatrizoic acid), cholangiography (ioglycamic acid), and cholecystography (Naiopanoate). After urography and cholangiography short-lived increases of the serum thyroxine occurred in a few patients, but the mean thyroxine and triiodothyronine concentration did not change. By contrast, 7 days after oral cholecystography serum thyroxine had risen consistently by 22% with a concomittant rise of the free thyroxine, while triiodothyronine declined by 15%. The thyroxine metabolite 3,3',5'-triiodo-1-thyronine (reverse T3) rose by 50% and serum thyrotropin concentration doubled. After 42 days thryoxine and triiodothyronine had returned to baseline, and none of the 58 patients developed clinical hyperthyroidism. In patients with severe myxoedema kept on a constant replacement dose with 1-thyroxine NA-iopanoate produced similar changes with the exception of the rise of the serum thyroxine. The primary event after Na-iopanoate seems to be a fall of the serum triiodothyronine, which in turn augments thyrotropin and indirectly thyroxine secretion. the marked and sometimes sustained rose of serum thyroxine after cholecystography may lead to the erroneous diagnosis of hyperthyroidism.

Adult↗

PubMed1991

Ultrasonic evaluation of gallbladder function prior to non-surgical treatment of gallstones.

A comparative analysis of ultrasonic and oral cholecystographic assessment of gallbladder function in symptomatic patients with cholelithiasis is presented. Ultrasonic evaluation demonstrated non-contractile gallbladders in all but one patient with non-opacification during oral cholecystography, whereas all those opacifying on oral cholecystography contracted on ultrasonography. Both techniques showed similar abilities to quantify the size and number of biliary calculi within the limits necessary to determine suitability for treatment. Although computed tomography remains necessary to quantify gallstone density prior to non-surgical treatment, ultrasonography is a safe, acceptable, cheap and preferable alternative to oral cholecystography in assessing gallbladder function.

Adult↗

PubMed1983

A sign of symptomatic chronic cholecystitis on biliary scintigraphy.

Five hundred patients with acute right-upper-quadrant pain underwent biliary scintigraphy with 99mTc paraisopropyliminodiacetic acid. One hundred and thirty-four studies were reported normal (both gallbladder and activity in bowel are noted in 1 hr). Of the 134 studies reported as normal, 32 showed intestinal activity before gallbladder visualization during the first hour of the study. Sonography and/or oral cholecystography revealed that 24 patients had gallstones, and eight patients had no demonstrable pathology in the biliary system. Of the 134 studies, 102 showed visualization of the gallbladder before intestinal activity during the first hour of the study. Sonography and/or oral cholecystography showed that 73 patients had normal biliary system. The remaining 29 patients had gallstones. The overall sensitivity of this finding is 45%, the specificity is 90%, and the accuracy is 73%. In this group of symptomatic patients, the appearance of intestinal activity before gallbladder activity on biliary scintigraphy warrants further evaluation of these patients by sonography and/or oral cholecystography.

Cholecystitis↗

PubMed1987

Chronic cholecystitis. An analysis of diagnostic strategies.

To define the optimal diagnostic approach for suspected chronic cholecystitis comprehensive management strategies were developed. Using a computer model, the frequency of appropriate surgery, inappropriate surgery, complications, death, and medical costs were compared in populations of patients with various disease prevalences. The optimal strategy began with ultrasonography, followed by an oral cholecystogram when the ultrasonogram was inconclusive. Oral cholecystogram also was employed when additional diagnostic studies failed to provide another explanation for the patient's symptoms. Compared with strategies using only ultrasonography or oral cholecystography, the combination strategy lowered the frequency of inappropriate surgery from 7.1 to 4.4% and direct medical costs from $1,877 to $1,766 per patient in a population with a 20% prevalence of chronic cholecystitis. The differences persisted at higher prevalences of cholecystitis and when sensitivities and specificities of the tests were varied over ranges reported in the literature. Diagnostic accuracy and direct medical costs could be improved by a more frequent interpretation of subtle abnormal ultrasonographic findings as inconclusive and by a more liberal use of oral cholecystography. This analysis demonstrates that a strategy combining ultrasonography and oral cholecystography is superior to the use of either test alone and is cost-efficient.

Cholecystitis↗

PubMed1985

The prospective diagnostic value of real-time cholecystosonography.

A series of 82 consecutive patients scheduled for operation, with pre-operatively obtained P.O. cholecystography and in some cases also I.V. cholangiography, is presented. All patients had cholecystosonography performed "blindly" the day prior to the operation (76 had a cholecystectomy and six had a vagotomy). Based upon the operative findings, the diagnostic value of ultrasonic examination for gallstones can be calculated to predictive value of positive test--1.00; predictive value of negative test--0.71. The diagnostic failures are discussed but it is not possible to predict which patients will benefit more from peroral cholecystography rather than from ultrasound. It is concluded that cholecystosonography is a safe alternative to peroral cholecystography.

Cholangiography↗

PubMed1977

The false-normal oral cholecystogram.

Five case reports of patients at Akron City Hospital who underwent cholecystectomy following normal oral cholecystograms and who were found to have cholelithiasis or acalculous gallbladder disease are presented. In spite of the present day 90 to 95 percent accuracy of oral cholecystography, there may be occasional pharmocological and mechanical factors contributing to the nonvisualization of biliary calculi. However, the gallbladder which visualizes normally during cholecystography, on occasion, may contain nonvisualized biliary calculi or may be diseased in the acalculous state, resulting in the so-clled false-normal x-ray and presents several means by which the surgeon may prove or disprove biliary disease. We conclude the emphasis must be placed on surgical judgment when a patient presents with symptoms of cholelithiasis in the face of normal oral cholecystography.

Adult↗

PubMed1976

The application of caerulein to cholangiography.

Caerulein was applied to oral cholecystography and the opacity of the common bile duct was evaluated at intervals. To 127 subjects whose gallbladder had been visualized by cholecystography was administered caerulein by intramuscular route in a dose of 0.2 mug per kg of body weight. As a result: 1. The visualization of the common bile duct reached its maximum 15 minutes after administration of caerulein (52% of the subjects); in total, 62.2% of the subjects responded to this cholecystography. 2. The visualization by caerulein was superior to that by the yolk both in its rate and intensity. 3. The cholangiogram taken after administration of caerulein was preferably available for diagnosis of bile duct lesions. Caerulein used for a pretreatment of drip infusion cholangiography (DIC) remarkably improved the picture in 3 of the 10 subjects in whom DIC alone had failed to show the bile duct. Thus, the application of caerulein to cholangiography facilitated diagnosis of bile duct lesions.

Bile Ducts↗

PubMed1980

Real-time ultrasonography. Diagnostic technique of choice in calculous gallbladder disease.

We used high-resolution real-time ultrasonography to examine the gallbladder in patients with signs and symptoms suggestive of gallbladder disease. Using this noninvasive technique, the physician can examine the gallbladder and related anatomy thoroughly in less than five minutes. The technique is much easier to learn and perform than gray-scale ultrasonography. In 313 patients in whom gallstones were later confirmed at cholecystectomy or autopsy, the ultrasound examination achieved an accuracy of 96 per cent in the evaluation of cholelithiasis. Five examinations gave false-negative results, one a definite false-positive result, and two possible false-positive results; six examinations were inadequate. The sensitivity of the method was 98 per cent, and the specificity was between 93.5 and 97.7 per cent. In 124 patients evaluated prospectively by means of both ultrasound and oral cholecystography, the ultrasound study revealed calculi in five patients in whom calculi were not demonstrated on an adequate oral cholecystogram. No calculus detected with oral cholecystography was missed by ultrasound. We believe that ultrasound should replace oral cholecystography as the first technique in evaluation of the patient with suspected gallbladder disease.

Cholelithiasis↗

PubMed1986

Gallstones, cholecystectomy, and duodenogastric reflux of bile acid.

It has earlier been suggested that cholecystectomy, by eliminating the reservoir function of the gallbladder, will induce reflux of bile to the stomach. In the present study 23 patients were studied for duodenogastric reflux of bile acid before and 3 months after cholecystectomy. At the test the gastric contents were continuously aspirated via a nasogastric tube, collected at 15-min intervals for 2 h in the fasting patient, and analyzed for volume and bile acid concentration. The results were compared with those in 14 control subjects. Significant duodenogastric reflux of bile acid (greater than 100 mumol/h) was seen more frequently in gallstone patients than in controls. This is explained by a high prevalence of bile acid reflux in patients with a reduced or absent opacification of the gallbladder at cholecystography. Cholecystectomy increased the prevalence of bile acid reflux in the patients with well-opacified gallbladders at cholecystography. The duodenogastric reflux of bile acid in patients with a poor filling of the gallbladder at cholecystography was not further enhanced by cholecystectomy. It is concluded that gallstone patients have an increased tendency to duodenogastric reflux of bile acid. This tendency is further enhanced by removal of a functioning gallbladder. The findings may explain some of the symptoms in patients with gallstones. The reflux may also be responsible for symptoms in the so-called postcholecystectomy syndrome.

Adult↗

PubMed1996

Extracorporeal shock-wave lithotripsy of gallbladder stones: an alternative for the selected few.

OBJECTIVE: To define selection criteria for optimal outcome of ESWL with oral litholysis (ursodeoxycholic acid) for gallbladder stones. DESIGN: Prospective study. SETTING: University hospital, Sweden. SUBJECTS: 145 patients with symptomatic gallbladder stones occupying a maximum of half the fasting gallbladder volume and gallbladder opacification at oral cholecystography. MAIN OUTCOME MEASURES: Three-year stone clearance rates in relation to initial stone burden, occurrence of calcified stones, and degree of gallbladder opacification at cholecystography. RESULTS: At all times clearance rates according to life table analysis were significantly higher for patients whose stone volume was < or = 4.2 ml (corresponding to one stone with a diameter of < or = 2.0 cm) (83% at 3 years) than for patients whose stone volume was > 4.2 ml (67% at 3 years), and patients with one stone had significantly higher clearance rates (88% at 3 years) than patients with multiple stones (58% at 3 years). Of all patients treated for gallbladder stones during one year, 25/194 (13%) had a stone volume of < or = 4.2 ml and 16/194 (8%) a solitary stone with volume < or = 4.2 ml. Neither the degree of gallbladder opacification nor the occurrence of calcified stones influenced clearance rates. CONCLUSION: ESWL may be an alternative to surgery in the few patients whose stone volume is roughly 4 ml or less and preferably have only one stone. Gallbladder function and patency of the cystic duct are poorly evaluated by oral cholecystography.

Adult↗

PubMed1982

Biliary colic and functional gallbladder disease.

We carried out a review of 358 patients undergoing cholecystectomy during a seven-year period. Twenty-one patients were found to have classic biliary colic with a normal oral cholecystogram. All patients were female and had symptoms for three to 120 months (mean, 24 months). Cholecystosonography, upper gastrointestinal (GI) tract x-ray series, and infusion tomography of the gallbladder, when performed, were normal. Twelve patients underwent cholecystokinin (CCK) cholecystography. Failure of normal contraction of the gallbladder was noted in all 12. All 21 underwent cholecystectomy; three months postoperatively, all patients were relieved of their pain, and 15 of the 16 available for long-term follow-up (averaging 22 months) were completely cured of their symptoms. We conclude that the young woman with typical biliary colic and a normal oral cholecystogram, gallbladder ultrasound study, and upper GI tract x-ray series should undergo CCK cholecystography. If the results are positive, these patients can be reliably cured by cholecystectomy.

Adult↗

PubMed1980

Ultrasound in elective biliary tract surgery.

The background, technique and ultrasonic criteria used in the diagnosis of biliary tract disease are reviewed and illustrative case histories and sonograms presented. The results in 100 prospective patients undergoing both biliary tract ultrasound and orall cholecystography are presented with surgical follow-up in 53 patients. Ultrasound was technically adequate in 96% of the patients examined and was accurate in 51 of the 53 patients who came to surgery. The gray scale ultrasound examination was more accurate than oral cholecystography, especially in the subgroup of patients with nonvisualizing oral cholecystograms. The current role of elective biliary tract sonography is discussed and gray scale ultrasound is recommended as the initial screening test in all patients with suspected biliary tract disease.

Adult↗