Cholecystosonography: Accuracy, pitfalls and unusual findings

doi:10.1016/0002-9610(80)90259-7

The American Journal of Surgery

Volume 139, Issue 2, February 1980, Pages 223-228

https://doi.org/10.1016/0002-9610(80)90259-7 Get rights and content

Abstract

Gray scale cholecystosonograms in 200 patients were reviewed. The findings in 133 of the patients were proved correct at surgery or autopsy. The overall accuracy for the detection of gallstones was 92 percent, with a false-negative rate of 4 percent. A false-positive diagnosis of cholelithiasis was made in three patients, two of whom proved to have extensive cholesterolosis. Causes of false-negative studies were the presence of a single small calculus, obesity and a large distended gallbladder. Ultrasound was specific but insensitive in the detection of a thickened gallbladder wall. The significance of a nonvisualized gallbladder by ultrasound and the role of ultrasound in the diagnosis of gallbladder disease are discussed.

References (14)

GR Leopold et al.
Gray scale ultrasonic cholecystography: a comparison with conventional radiographic techniques
Radiology
(1976)
S Arnon et al.
Gray scale cholecystosonography: an evaluation of accuracy
Am J Roentgenol
(1976)
TL Lawson
Gray scale cholecystosonography: diagnostic criteria and accuracy
Radiology
(1977)
RJ Bartrum et al.
Ultrasonic and radiographic cholecystography
N Engl J Med
(1977)
M Grade et al.
Surgical and pathologic correlation of cholecystosonography and cholecystography
Am J Roentgenol
(1978)
HC Crow et al.
Expanded criteria for the ultrasonic diagnosis of gallstones
J Clin Ultrasound
(1976)

There are more references available in the full text version of this article.

Cited by (16)

Cholelithiasis in the Syrian population. A prospective study of 189 patients
1987, The American Journal of Surgery
A prospective study of 189 Syrian patients with cholelithiasis was performed to throw light on some features of the disease in Syria. Early or emergency cholecystectomies were performed in 28 percent of all operations, whereas elective operations were carried out in the remaining patients. Explorations of the common bile ducts were performed in 34 patients, only 4 of whom had no stones. Wound and chest infections represented the most common postoperative complications. There was only one postoperative death, which was reportedly due to massive hemorrhage from esophageal varices. Analysis of the stones removed after cholecystectomies revealed that 72.4 percent were of mixed composition, 19.4 percent were pure cholesterol, and 8.2 percent were pigmented stones.
Gallbladder disease in the morbidly obese
1985, The American Journal of Surgery
During a 7 year period, 200 consecutive morbidly obese patients underwent a standardized gastric exclusion procedure. Group A was composed of the first 120 patients and Group B of the last 80 patients. In Group A, 22 patients had undergone a previous cholecystectomy and 12 patients had a cholecystectomy at the time of gastric exclusion because of positive diagnostic studies or palpation of stones. Of the remaining 87 patients in this initial group who were at risk for the development of gallbladder disease, 24 (27.6 percent) required a cholecystectomy in the first 3 postoperative years (mean 15.6 months). Twelve patients had acute cholecystitis, 3 patients had choledocholithiasis, and 1 patient had acute gallstone pancreatitis. In Group B, 18 patients had a previous cholecystectomy, 15 had positive diagnostic studies (ultrasonography and oral cholecystography) preoperatively, and 47 had negative studies. Cholecystectomy was routinely performed at the time of gastric exclusion surgery in the 62 patients with gallbladders in Group B. Of the 47 patients who had normal preoperative diagnostic studies, 40 (85.1 percent) had abnormal histologic findings in the gallbladder. Only seven patients in Group B had a normal gallbladder (14.7 percent). We conclude that gallbladder disease is considerably more frequent in the morbidly obese population (91.3 percent) than has previously been recognized, that diagnostic studies are frequently inaccurate, and that postoperative gallbladder disease is common (28.7 percent). On the basis of these results, routine cholecystectomy at the time of gastric exclusion surgery is recommended.
The National Cooperative Gallstone Study and current management of cholesterol cholelithiasis-Two views. The National Cooperative Gallstone Study viewed by its investigators
1983, Gastroenterology
Perioperative management of cholelithiasis in patients presenting for laparoscopic Roux-en-Y gastric bypass: Have we reached a consensus?
2009, American Surgeon
Gallbladder disease in the bariatric surgery patient
2007, Minimally Invasive Bariatric Surgery
EXPERIENCE WITH BILIARY AUDIT
1991, Australian and New Zealand Journal of Surgery

View all citing articles on Scopus

¹: From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.

View full text

Scientific paperCholecystosonography: Accuracy, pitfalls and unusual findings

Abstract

Gray scale ultrasonic cholecystography: a comparison with conventional radiographic techniques

Radiology

Gray scale cholecystosonography: an evaluation of accuracy

Am J Roentgenol

Gray scale cholecystosonography: diagnostic criteria and accuracy

Radiology

Ultrasonic and radiographic cholecystography

N Engl J Med

Surgical and pathologic correlation of cholecystosonography and cholecystography

Am J Roentgenol

Expanded criteria for the ultrasonic diagnosis of gallstones

J Clin Ultrasound

Scientific paper
Cholecystosonography: Accuracy, pitfalls and unusual findings