Cholecystokinin cholecystography in the differential diagnosis of acalculous gallbladder disease

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

“…The radiographic and symptomatic response after CCK injected in 15-30 s are given in Tables 2 and 3. Nathan et al differed from Goldstein et al [20] in that they did not concern themselves with the degree of gallbladder emptying, but only considered spasm of the gallbladder to be significant. Transient spasm of the cystic duct was evident in both the patient group and controls.…”

“…Goldstein et al [20] criticized Dunn's study on the basis that the rapid injection rate of CCK (45 s) that was used is capable of producing spasm of the cystic duct in most normal individuals. However, the data reported by Nathan et al show such spasm is transient and rarely lasts longer than three or four min " [16].…”

“…Goldberg was equally sanguine about the value of CCK cholecystography to detect patients with disease of the biliary tract in the presence of a normal conventional cholecystogram [7]. He defined a positive test more stringently than Goldstein et al [20] or Nathan et al [16] and required that to be considered abnormal, the gallbladder must both contract less than 20% on the radiographs and the patient must have reproduction of pain. Goldberg reported that 14 of 15 patients with a positive response to CCK who had a cholecystectomy were completely cured, or had marked improvement during the followup period of 6 months to 4 years [7].…”

“…Goldstein et al were enthusiastic about their experience with CCK cholecystography performed between 1959 and 1972 in which the diagnosis of the cystic duct syndrome was apparently made correctly on the basis of a positive test in 28 patients [13][14][15][18][19][20]. The response to CCK was considered abnormal when the gallbladder emptied less than 50%.…”

Assessment of gallbladder function using ceruletide in oral cholecystography

“…It has been claimed that the intravenous injection of cholecystokinin may provoke visible abnormalities in gallbladders and bile ducts which have been opacified by oral cholecystography and that symptoms referable to the biliary tract may simultaneously be provoked in susceptible cases [7][8][9].…”