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Ceruletide in a dose of 0.25 microgram/kg of body weight intramuscular has been used for cholecystokinetic purposes during oral cholecystography in 42 patients. Results were favourable and trouble-free. Radiographs of 7 cases are presented.
Retrospective and prospective studies were done to evaluate the efficacy of oral cholecystography (OCG) performed before hospital discharge on alcoholic patients with acute pancreatitis. In the retrospective study, OCG adequately opacified the gallbladder in 21 of 26 patients (81%). Of the 5 patients with inadequate opacification, 1 was jaundiced at the time of OCG; the other 4 had OCG before resumption of solid food. In the prospective study, OCG done in nonjaundiced patients shortly after resumption of food yielded adequate opacification in 19 of 21 patients (90%) without gallstones. We conclude that in nonjaundiced alcoholic patients with acute pancreatitis not caused by gallstones, OCG performed after resumption of a solid diet and before hospital discharge is usually successful in opacifying the gallbladder.
A method of intraperitoneal cholecystography is described and was tested on mice with experimentally induced gallstones. The presence of stones in the gallbladder was predicted with an accuracy of 95.5%, using doses of 3 ml of 51.6% meglumine iodipamide (Cholografin) per kg diluted 10-fold, followed a few days later by a repeat dose of 5 ml per kg in cases of nonvisualization of the gallbladder. Pilot studies on guinea pigs and rabbits suggest that this method is applicable to these animals too, although a higher dose of contrast medium is required.
A dose (3 g) of sodium ipodate used routinely in oral cholecystography caused a fall in serum 3,5,3'-triiodothyronine and a rise in serum 3,3',5'-triiodothyronine in three patients taking thyroxine (T4), four euthyroid subjects,and four hyperthyroid patients. Serum T4 fell in patients with hperthyroidism, whereas it rose in the other two groups. Sodium ipodate appears to alter peripheral T4 metabolism and, in addition, produces thyroid-inhibiting effects in hyperthyroidism.
The tolerance and diagnostic usefulness of the new intravenous bile contrast medium Endomirabil were subjected to clinical radiological testing. Endomirabil is well tolerated. It is our impression that it has a lower side effect quota than the other contrast media used so far. Diagnostic results in injection cholangiography and cholecystography with 30 ml Endomirabil were good. In more than 80% of the cases the bile ducts were well demonstrated. The diagnostic evaluation was fully satisfactory. In most cases both the bile ducts and the gallbladder showed up very well within 60 minutes after completion of the injection. This means both film material and time are saved.
The aim of the study is to demonstrate general function of the cholecyst through selected quantitative parameters derived from the quantitative radionuclide cholecystography method, using our own computer software HIDATA, and to evaluate values of specific quantitative parameters in 15 patients presenting with chronic calculous and 15 with chronic acalculous cholecystitis. A control group comprised 10 subjects with no changes on the cholecyst. Of four quantitative parameters calculated during cholecyst filling, the only significant one was the ascending segment slope of the curve from specific ROI, that is, K1 derived from it, because it shows its functional status, depending on the changes in its wall and the lumen content. The most significant parameters which maintain motor function of the cholecyst are ejection fraction (EF) and ejection rate (ER) which are always decreased in chronic cholecystitis, regardless of the presence of calculosis and the number of calculi in the lumen. The ejection fraction is especially decreased in the multiple sclerosis group; it is significantly decreased when compared with acalculous chronic cholecystitis. Our results indicate that a selection of parameters used in clinical practice for the assessment of the cholecyst function is necessary. Our program HIDATA included a large number of parameters of which three were classified as important for the assessment of the cholecyst function (K1, EF, ER), reflecting the process of filling and emptying of the cholecyst and offering reliable and valuable data for the treatment.
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