Cholecystography

Summary

Oral cholecystography is a radiological procedure used to visualize the gallbladder and biliary channels, developed in 1924 by American surgeons Evarts Ambrose Graham and Warren Henry Cole. It is usually indicated in cases of suspected gallbladder disease, and can also be used to determine or rule out the presence of intermittent obstruction of the bile ducts or recurrent biliary disease after biliary surgery.[1]

Cholecystography
ICD-9-CM87.59
MeSHD002765
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A radiopaque cholegraphic (contrast) agent, usually iopanoic acid (Telepaque) or its sodium or calcium salt,[2] is orally administered, which is absorbed by the intestine. This excreted material will collect in the gallbladder, where reabsorption of water concentrates the excreted contrast. Since only 10% of gallstones are radiopaque, the remaining 90% will appear as translucent on an opaque background in an abdominal X-ray.

If needed, intravenous cholecystography and cholangiography may be done.[citation needed]

Current medical practice prefers ultrasound and CT over oral cholecystography.[3]

InterpretationEdit

Failure of gallbladder visualisation during oral cholecystography when abnormal liver function returns to normal, or there is mild to moderate liver disease, maybe due to extrahepatic (outside the liver) causes.[4] Oral cholecystography can have better sensitivity and specificity in diagnosing acute and chronic gallbladder disease than ultrasound.[5]

ReferencesEdit

  1. ^ "Cholecystography". Encyclopædia Britannica.
  2. ^ "Cholegraphic contrast medium". Medcyclopaedia. GE.
  3. ^ Duncan, C; Riall, T (2012). "Evidence-Based Current Surgical Practice: Calculous Gallbladder Disease". J Gastrointest Surg. 16 (11): 2011–2025. doi:10.1007/s11605-012-2024-1. PMC 3496004. PMID 22986769.
  4. ^ MANDEL W, GAINES LM, MARILLEY RJ (March 1956). "Evaluation of oral cholecystography in liver disease". A.M.A. Archives of Internal Medicine. 97 (3): 335–9. doi:10.1001/archinte.1956.00250210081007. PMID 13291912.
  5. ^ Robles A, Devor D, Wang H, Warren C (October 1987). "Oral cholecystography and sonography of gallbladder in cholecystectomy patients". The Western Journal of Medicine. 147 (4): 432–4. PMC 1025903. PMID 3318137.