[Importance of cholegraphy for indicating litholysis]

Today patients with gallstones are treated surgically, by means of drugs, or by endoscopy. However, only cholesterol stones can be dissolved with bile acids. Besides the cholesterol stones in the gallbladder, insoluble pigment stones or insoluble stones with a high inorganic calcium content will be found. In every patient, the solubility of the gallbladder stones must be established by mineralogical analysis. Sonography is very helpful in detecting gallbladder stones, but it is impossible to perform a mineralogical analysis with this method. Plain radiography is likewise insufficient. The only way to obtain a relatively accurate selection of patients with soluble gallstones is the performance of roentgenography after cholecystography. Cholecystography for mineralogical analysis must always follow detection of gallstones by sonography.