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Biliary colic and functional gallbladder disease

A E Rajagopalan, J Pickleman

    Archives of Surgery (Chicago, Ill. : 1960)
    |August 1, 1982
    PubMed
    Summary
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    Young women experiencing biliary colic with normal diagnostic tests may have gallbladder dysfunction. Cholecystokinin (CCK) cholecystography can identify this, and cholecystectomy often provides symptom relief.

    Area of Science:

    • Gastroenterology
    • Diagnostic Imaging

    Background:

    • Biliary colic is a common condition.
    • Standard diagnostic tests can be normal in some patients with biliary colic.

    Purpose of the Study:

    • To evaluate the utility of cholecystokinin (CCK) cholecystography in diagnosing gallbladder dysfunction in patients with biliary colic and normal conventional imaging.
    • To assess the efficacy of cholecystectomy in treating these patients.

    Main Methods:

    • Retrospective review of 358 cholecystectomies over seven years.
    • Detailed analysis of 21 female patients with biliary colic and normal oral cholecystograms, ultrasounds, and upper GI series.
    • Performance of cholecystokinin (CCK) cholecystography in 12 patients.

    Main Results:

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    • All 21 patients were female with prolonged symptoms (mean 24 months).
    • Conventional imaging (oral cholecystogram, ultrasound, GI series) was normal in all.
    • CCK cholecystography revealed abnormal gallbladder contraction in all 12 patients tested.
    • Post-cholecystectomy, 100% of patients experienced pain relief, with 15/16 achieving complete symptom cure at 22 months follow-up.

    Conclusions:

    • CCK cholecystography is a valuable tool for diagnosing gallbladder dysfunction in women with biliary colic and normal initial imaging.
    • Cholecystectomy is an effective treatment for selected patients with biliary colic secondary to gallbladder dysfunction.