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The influence of fasting on opacification of the gallbladder during oral cholecystography using two consecutive doses in a canine model.

Oral cholecystography was performed in eight adult mongrel dogs. Contrast agents (Telepaque and/or Bilopaque) were administered in six different combinations, given as two consecutive doses with and without food. A combination of Bilopaque alone on both days and a combination of Telepaque with food on the first day and Bilopaque alone on the second day each proved to be the best method in 37.5% of the dogs. Telepaque with food on both consecutive days was the best method in 25% of the dogs. Among the eight combinations, two consecutive doses of Bilopaque alone or a combination of Telepaque with food on the first day and Bilopaque alone on the second day resulted in the most dense opacification of the gallbladder. Clinical implications of these results are discussed.

Administration, Oral↗

The prevalence of cholelithiasis in sickle cell disease as diagnosed by ultrasound and cholecystography.

Gallbladder disease is known to be increased in sickle cell disease (SS). The prevalence of cholelithiasis in children with SS has been reported as 10% to 37%. Gallbladder ultrasound, cholecystography, and/or abdominal radiography were used to evaluate 31 patients aged 2 to 18 years with no systematic evidence of gallbladder disease for cholelithiasis, Overall prevalence of gallstones was found to be 29%. Cholelithiasis was detected in children as young as 4 years of age. Prevalence below the age of 10 years and above the age of 10 years was found to be 11% and 55% respectively. The increased prevalence of cholelithiasis in children with sickle cell disease suggests the use of diagnostic ultrasonography as a routine screening procedure.

Adolescent↗

Common bile duct visualization with a nonvisualized gallbladder in oral cholecystography: radiological and surgical study.

A series of 203 cholecystectomied patients in which the gallbladder was not visualized in oral cholecystography is analysed. In 72 cases the common bile duct was seen. In 4 cases it was dilated. At operation, cholecystolithiasis was found in 189 cases, a calculus in the common bile duct in 3 cases, and a neoplasm in 3 cases. In 6 cases there was inflammation but no calculi. Administration of 2 g of sodium iopanoate on 2 successive days before the examination seems to result in frequent visualization of the common bile duct. It also seems to be an accurate method in biliary tract disease when the gallbladder was not adequately visualized.

Cholecystitis↗

[Injection cholecystography--influence of radiopaque substance and injection time on the excretion of contrast media and incidence of side effects].

In a total of 532 patients, Bilivistan and Endomirabil are compared in cholecystography regarding side effects and visualization. Endomirabil clearly demonstrates the advantage of better tolerance. It is shown that slow and constant injection leads to a decrease in the rate of adverse reactions and improvement of radiographic demonstration.

Adult↗

The effect of intravenously administered sincalide on the human gallbladder during oral cholecystography.

Sincalide, the C-terminal octapeptide fragment of the cholecystokinin, was used to contract the gallbladder during routine oral cholecystography in 18 patients. In 14 patients clinically important contraction occurred. The average reduction in gallbladder size for these patients was 32.7% of the preinjection size (range 15.1%-67.9%). Within 8-12 minutes cystic duct visualisation occurred in 8 and common bile duct visualisation in 3 patients. Spasm of the gallbladder neck was found in 2 cases. The blood pressure and heart rate did not change significantly during the study. Six patients felt slight nausea for 1-4 minutes and two vomited. We conclude that sincalide may be useful in biliary tract function studies in special clinical conditions (i.e. upper abdominal pain with unknown aetiology).

Adult↗

[The value of ceruletide in oral cholecystography].

The action of Ceruletide, a decapeptide with a chemical formula close to that of the terminal acid amines of cholecystokinin pancreozymin, was investigated during oral cholecystography. Intramuscular injections of Ceruletide provoked gallbladder contractions that were stronger and occurred more rapidly than after the conventional "fatty meal". Visualization of the extrahepatic biliary pathways was improved, the duration of the examination shortened, and the number of films required reduced, the useful time in approximately 3 out of 4 cases being equal to or less than 6 minutes.

Adolescent↗

The reliability of cholecystography with calcium ipodate augmentation.

Sixty-one patients who underwent augmentation cholecystography with calcium ipodate (Oragrafin calcium granules) were reviewed. Sixty-four per cent (39/61) of nonvisualizing or poorly visualizing cholecystograms were converted to well-visualizing studies, of which 26 per cent (10/39) involved cholethiasis. In 55 per cent of the cholecystograms (12/22) that remained nonvisualizing or poorly visualizing, patients were found to have gallstones. The remaining cases of poor or nonvisualizing cholecytograms were associated with abnormal liver function, cholecystitis, and pancreatitis. If the gallbladder is nonvisualized with a calcium ipodate augmentation technique it is reliable evidence of gallbladder disease, and is likely cholelithiasis when extrinsic factors affecting contrast absorption or liver function are excluded.

Cholecystography↗

Accuracy of oral cholecystography in cholelithiasis.

The accuracy of oral cholecystograms in the detection of cholelithiasis was assessed by comparing 100 patients who were examined both roentgenographically and by ultrasonography of the gallbladder. All normal oral cholecystograms had normal ultrasonography of the gallbladder. This study supports previous reviews indicating that the reliability of cholecystography in cholelithiasis is in the 98% range.

Cholecystography↗

Normal findings in oral and cholecystokinin cholecystography.

Normal findings in oral cholecystography and normal response of the gallbladder to cholecystokinin are established in 200 normal controls. These include absence of right upper quadrant pain in 98.5%, absence of spasm of the body of the gallbladder and of severe spasm in the fundus, a common bile duct diameter of 6 mm or less in those 182 that were visualized, and gallbladder size of less than 11 cm in length in about 97% and less than 4 cm in width in about 97%. If normal contraction occurs after cholecystokinin (or sincalide), an unusually large gallbladder is of no importance. Little or no gallbladder contraction in the presence of normal concentration is probably of no importance.

Administration, Oral↗

[Comparative evaluation of cholecystography, cholangiography, echotomography and cholescintigraphy in surgical disorders of the bile ducts].

The results of a multidiscipline trial conducted on 70 patients with cholecyst or bile duct diseases, including 20 complicated by icterus, are presented. the diagnostic significance of cholecystography and cholangiography supplemented by echotomography and HIDA cholescintigraphy was assessed. A personally employed protocol for the diagnosis of patients with cholecyst and bile duct disorders, covering both simple lithiasis and cases complicated by icterus, is proposed.

Adult↗

Sodium taurocholate, ineffective as an adjuvant in oral cholecystography.

The effect of 6 g sodium taurocholate on the visualization of the gall bladder with calcium iopodate (Solu-Biloptin, Leiras, Schering AG) was studied on 140 patients with a control group of 99 patients. The administration of sodium taurocholate with a contrast medium did not improve the opacification of the gall bladder in oral cholecystography with calcium iopodate but induced a significant increase in side effects.

Adolescent↗

[Cholecystography and ultrasonics in the diagnosis of gallstones].

Oral cholecystography and ultrasonography of the gallbladder were performed in 190 patients with the aim of diagnosing gallstones. At surgery gallstones were found in 23 patients and a roundworm in 1 patient. The results obtained with the two methods are comparable. Since neither radiation nor contrast agents are employed in ultrasonography, it is suggested that this be regarded as the primary special examination in the diagnosis of gallstones.

Cholecystography↗

Ultrasonography of the gallbladder. Investigation of the nonvisualized gallbladder at oral cholecystography.

One hundred and one patients with nonvisualized gallbladder at double dose oral cholecystography were examined with ultrasonography. In 41 of 44 operated patients, ultrasonography suggested gallbladder disease. Operation in all of these cases confirmed the diagnosis. In three of the patients with cholelithiasis operation revealed in addition gallbladder carcinoma. In three patients, in which ultrasonography demonstrated normal appearance of the gallbladder surgery revealed chronic cholecystitis and stone impacted in the cystic duct. The diagnostic value of ultrasonography as complementary method for evaluation of gallbladder disease, particularly in cases of nonvisualization of the gallbladder at ultrasonography is stressed. The high incidence of gallbladder carcinoma in the present material in patients with cholelithiasis point to the fact that this group of patients should be the subject for careful investigation.

Adult↗

Prolonged opacification of the gallbladder after oral cholecystography: a reevaluation of its clinical significance.

The frequency of prolonged opacification of the gallbladder after oral cholecystography was determined in several conditions that are manifestly or reputedly associated with gallbladder dysfunction: in patients with gallstones, in cases of "biliary colic" with normal cholecystograms, in postvagotomy patients, and in diabetics. These groups were compared with asymptomatic controls and to patients with irritable bowel syndrome. A dietary fat intake of at least 50 g between the first and last films taken was ensured in all subjects. The effect of fat deprivation was separately studied in asymptomatic controls. Prolonged opacification was encountered in approximately two-thirds of patients with gallstones, in two-thirds of patients with "acalculous biliary colic," in two-thirds of healthy subjects deprived of fat, and in about one-third of postvagotomy patients and diabetics. It was not seen in a single patient with irritable bowel syndrome, and it was encountered in only 1 out of 17 controls whose diet included a fat supplement. These differences were highly significant (p less than 0.0001).

Adult↗

[On the diagnosis of the duodenal ulcer in oral cholecystography (author's transl)].

Retention of contrast medium in oral cholecystography, manifested by an incomplete ring or any other sign in the right epigastrium, is a rare occurrence. However, if such retention is discovered, the roentgenologist must immediately suspect the presence of an active duodenal ulcer, so that it will be imperative to perform contrast medium examination of th stomach right away.

Adult↗

Oral cholecystography: is the fatty meal always necessary?

In our study we have collected 1000 consecutive cases of oral cholecystographic opacification of the gall-bladder and common bile duct; occasionally a complimentary intra-venous cholangiography had also been carried out. In 360 cases there was disease of the gall-bladder or a faint opacification of the common bile duct was abnormal in only three cases, which is a rate of 0,47%. Therefore the fatty meal after oral cholecystography should not be done in each case but only if there is a presumptive diagnosis of pancreatic disease, if there is pancreatic calcification, or if surgery has been previously performed on the biliary tract or duodenum.

Adult↗

Cholecystokinin cholecystography in the diagnosis of acalculous extrahepatic biliary tract disorders.

Cholecystokinin cholecystography represents a study designed to identify patients with acalculous extrahepatic biliary tract disorders. In this study, a positive cholecystokinin cholecystogram (CCK-GB) was defined as both reproduction of the patient's biliary tract-type pain plus one or more of various roentgen abnormalities. Using these criteria, 20 patients had a positive CCK-GB. After failure of medical management, 19 of these patients came to surgery. Seventeen of 18 available for follow-up were cured of their biliary tract pain by surgery. Follow-up of this group of patients has ranged from one month to 60 months. In view of our findings plus those in other reported series, we conclude that CCK-GB provides a reliable study for the diagnosis of acalculous extrahepatic biliary tract disorders.

Adolescent↗