Comparison of oral cholecystography and ultrasonography for evaluating chronic cholecystitis using patient outcome as the reference standard.

Rationale And Objectives: The authors compared oral cholecystography (OCG) with ultrasound (US) in the detection of chronic gallbladder disease using clinical outcome, rather than pathology results, as the reference standard.

Methods: The authors interviewed 269 patients who underwent either OCG, US, or both, for evaluation of chronic right upper quadrant abdominal pain. The authors considered patients who underwent cholecystectomy with improved symptoms 1 to 4 years after surgery to be reference-standard positive for gallbladder disease, and patients with objective evidence of an alternative diagnosis (eg, peptic ulcer disease), which improved with therapy as reference-standard negative.

Results: The sensitivity and specificity of OCG were 83% and 97%, respectively, and for US, 86% and 90%, respectively.

Conclusions: OCG is comparable with US in evaluating of chronic gallbladder disease. In institutions where OCG is used for diagnosing chronic cholecystitis, it may be reasonable to continue using OCG.