Chronic acalculous gallbladder disease: multiimaging evaluation with clinical-pathologic correlation
Department of Medicine, Division of Cardiovascular Medicine
Medical Subject Headings
Adult; Aged; Cholecystitis; Chronic Disease; Female; Humans; Male; Middle Aged; Ultrasonography
Bioinformatics | Biostatistics | Epidemiology | Health Services Research
Despite the recent advances in hepatobiliary imaging, the diagnosis of chronic acalculous gallbladder disease remains difficult. A retrospective study was undertaken to assess the value of a multiimaging approach in detecting chronic acalculous gallbladder disease and in predicting which patients would obtain symptomatic relief after cholecystectomy. Of 199 patients with chronic cholecystitis, 26 (13%) had no gallstones. Of these 26, only 17 (65%) had symptoms related to chronic cholecystitis; in the remainder, the histologic diagnosis was made incidentally. After cholecystectomy, 13 (76%) of the 17 symptomatic patients obtained long-term symptomatic relief, while in four, the symptoms recurred. Among patients with histologic changes of chronic cholecystitis, biliary scintigraphy was the most sensitive technique (sensitivity, 89%). The sensitivity of sonography and oral cholecystography was 61.5% and 66%, respectively. However, for identifying symptomatic patients who may obtain long-term symptomatic relief after cholecystectomy, the accuracy of sonography, oral cholecystography, and biliary scintigraphy was 82%, 86%, and 38%, respectively. When two tests were in agreement the accuracy was 88%. For chronic acalculous cholecystitis, more than one study must be performed in order to make the correct diagnosis and to predict good results from cholecystectomy.
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Citation: AJR Am J Roentgenol. 1986 Oct;147(4):721-4.
Raptopoulos, Vassilios; Compton, Carolyn C.; Doherty, Paul; Smith, Edward H.; D'Orsi, Carl J.; Patwardhan, Nilima A.; and Goldberg, Robert J., "Chronic acalculous gallbladder disease: multiimaging evaluation with clinical-pathologic correlation" (1986). Quantitative Health Sciences Publications and Presentations. 204.