Cholecystokinin Cholecystography in the Diagnosis of Gallbladder Disease

Abstract

Twenty-six patients who had typical symptoms of biliary tract disease, e.g., postprandial right upper quadrant pain, nausea and vomiting, fatty food intolerance and flatulence and who had had 2 or more normal oral cholecystograms were subjected to cholecystokinin cholecystography. Ten patients showed a normal response to the i.v. administration of cholecystokinin, i.e., prompt and complete emptying of the gallbladder without producing any adverse reaction or symptoms. Sixteen patients demonstrated either no contraction or incomplete contraction of the gallbladder in response to cholecystokinin; several patients had moderate contraction of the gallbladder accompanied by symptoms of biliary colic. The latter group underwent cholecystectomy and operative cholangiography. Fifteen of the 16 patients are asymptomatic or improved, and only 1 patient continues to have symptoms. All removed gallbladders had histologic evidence of chronic cholecystitis. In some individuals with continuing symptoms suggesting gallbladder disease but normal oral cholecystograms, cholecystokinin cholecystography may be helpful in identifying physiologic dysfunction of the gallbladder.