Results of combined biliary drainage and cholecystokinin cholecystography in 81 patients with normal oral cholecystograms

M. J. Burnstein, K. P. Vassal, S. M. Strasberg

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)627-632
Number of pages6
JournalAnnals of surgery
Volume196
Issue number6
DOIs
StatePublished - Jan 1 1982
Externally publishedYes

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