Cholecystokinin cholecystography in the diagnosis of chronic acalculous cholecystitis and biliary dyskinesia

Abstract

Abstract. Now that the active fragment of the cholecystokinin molecule has been made available for use in clinical practice, reports on the value of cholecystokinin cholecystography must be re-evaluated to determine if the procedure is worthwhile in patients with persistent symptoms and a normal conventional oral cholecystogram. Such an analysis discloses that there is no uniform agreement on what constitutes an abnormal examination and raises serious questions concerning the scientific validity of much of the data. It is apparent that there is no immutable evidence to date to indicate that cholecystokinin cholecystography is an accurate technique to determine which patients in this category will benefit from cholecystectomy.

Efficacy of laparoscopic cholecystectomy in the pediatric population

“…These numbers are often used as a tool for the diagnosis of biliary dyskinesia, but Patel et al [19] noted that patients with EFs considered "normal" may also benefit from surgical intervention. These results have been reproduced throughout the adult and pediatric literature [4,[20][21][22][23].…”

Use of the C-terminal octapeptide of cholecystokinin in clinical radiology

“…Results of the present study are relevant to cholecystokinin cholecystography [9][10][11][12][13][14][15].…”

“…Cholecystokinin cholecystography as a method has been severely criticized [12,15]. Goldberg [14] has recently summarized the past 15 years' experience with CCK cholecystography.…”

Assessment of gallbladder function using ceruletide in oral cholecystography

“…Despite these inconsistencies, all these authors concluded that the majority of patients who underwent cholecystectomy on the basis of a positive CCK cholecystogram, but a normal conventional cholecystogram, were cured of their biliary symptoms. As Berk [13] has pointed out, no matter which criteria are used to define a positive examination or how the cholecystokinin is injected, there are a very few false-positive CCK cholecystograms. The incidence of false-negative tests, however, had not been determined because no patients with negative responses to cholecystokinin had cholecystectomy.…”

“…-20 20-40 40-60 60-80 80-100 100 5 8 34 30 16 8 4 0 10 6 22 22 20 10 20 0 20 6 16 16 14 22 22 4 40 8 8 12 16 30 12 14 The disorders claimed to be discerned in this way have been variably termed the cystic duct syndrome [10], acalculous gallbladder disease [11], and biliary dyskinesia [12]. Others [13,14] have disputed the validity of cholecystokinin cholecystography.…”