Cholecystokinin cholecystography. Controlled evaluation in the diagnosis and management of patients with possible acalculous gallbladder disease

X-ray films of the opacified gallbladder (ipodate [Oragrafin] sodium) were taken at intervals following intravenous injection of cholecystokinin in 44 control subjects and in 74 patients with a history suggestive of gallbladder disease, but in whom routine cholecystography was normal. Abnormal results were found in 30% to 40% of the patient group, but the incidence of "false-positive" results was high in the control group (14%, 34%, and 36%, according to three radiologists). Because of continued pain, 29 of the patients were subjected to cholecystectomy. The clinical response to surgical treatment and the histologic findings in the resected gallbladders were similar in patients with "normal" and "abnormal" preoperative cholecystokinin cholangiographic studies. It is concluded that cholecystokinin cholecystography, as currently employed, is not helpful in the diagnosis and management of patients with possible acalculous gallbladder disease. (JAMA228:997-1003, 1974)