Open AccessResults of Combined Biliary Drainage and Cholecystokinin Cholecystography in 81 Patients with Normal Oral Cholecystograms
Author(s) -
Marcus J. Burnstein,
K. P. Vassal,
Steven M. Strasberg
Publication year - 1982
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198212001-00001
Subject(s) - medicine , cholecystography , cholecystectomy , gallbladder , cholecystokinin , gastroenterology , intubation , biliary drainage , biliary colic , radiology , surgery , receptor
Combined biliary drainage-cholecystokinin cholecystography (BD-CC) was evaluated in 81 patients with pain indistinguishable from biliary colic, but normal conventional diagnostic tests. The test was performed using a new technique of intubation and aspiration, with a steerable catheter and sump duodenal tube. Both positive and negative groups were followed. One third of patients had positive tests, and almost all had pathologic gallbladders, and a symptomatic outcome equal to that obtained by cholecystectomy for cholelithiasis diagnosed by conventional means. Some patients with severe pain had cholecystectomy despite a negative report. Pathologic findings were significantly fewer, and symptomatic outcome less satisfactory but sufficiently good to suggest that painful functional gallbladder abnormalities, not amenable to diagnosis by BD-CC exist. Hypercontraction was found to be a reliable index of gallbladder pathology. A false bilirubin precipitate was identified in some patients; this precipitate may be recognized by microscopy and pH testing. This finding should reduce false-positives in BD-CC.