INTRAVENOUS CHOLANGIOGRAPHY WITH INTACT GALLBLADDER

¹ Resident in Radiology.

Results of intravenous cholangiography as carried out for 133 patients who had not undergone cholecystectomy were studied. Opacity of the gallbladder was obtained in 88 cases.

Opacification of the bile duct without visualization of the gallbladder was found to be caused by complete mechanical obstruction of the cystic duct by stone or edema in about a third of the patients for whom surgical exploration subsequently was done. Of the remaining patients, most were found to have free gallstones at operation, but in about an eighth of the cases there was no anatomic reason for nonfilling of the gallbladder.

Delay in opacification of the gallbladder beyond 25 minutes, but within 135 minutes, did not seem to be influenced by the presence of stones in the gallbladder. Delay occurred in 35 per cent of those patients who had stones and in 45 per cent of those who did not.

Cholelithiasis later proved surgically was detected by intravenous cholangiography in 6 of 11 cases (55 per cent) in which the gallbladder was visualized. Choledocholithiasis was detected in 9 of 19 cases (47 per cent) in which the condition subsequently was proved at operation. In some cases, however, gallstones not demonstrated by oral cholecystography were disclosed by the intravenous examination.

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