Cholecystokinin Cholecystography in Acalculous Gallbladder Disease

Symptomatic acalculous gallbladder disease presents a difficult therapeutic problem. Several patients with acalculous gallbladder disease had prolonged visualization of the gallbladder following oral cholecystography with iopanoic acid even after stimulation with a fatty meal. Cholecystectomy was performed on 14 of these patients. Subsequently, we instituted cholecystokinin cholecystography in an effort to detect abnormal function or the presence of disease. An abnormal response with deficient emptying was demonstrated in ten additional patients in whom cholecystectomy was done. The operative and pathological findings and a follow-up are presented in all 24 cases. These consisted of such findings as thickness of the gallbladder wall, kinking of the cystic duct, chronic cholecystitis, papilloma, and cholesterolosis. Cholecystokinin cholecystography added a dimension to the diagnosis of clinically important abnormal gallbladder function by providing maximum stimulus to contraction of the gallbladder that had been shown by conventional cholecystography to empty very slowly.