Fatty meal provocation monitored by ultrasonography. A method to diagnose ambiguous gallbladder disease.

Impaired gallbladder emptying is a recognized sign of acalculous gallbladder disease (AGBD). The emptying function was studied by ultrasonographic monitoring before and after ingestion of fat-containing food in a prospective study comprising 124 patients (136 examinations). In 17 patients the antero-posterior diameter of the gallbladder was unchanged or increased postprandially in addition to the onset of abdominal pain and nausea, signs interpreted as consistent with AGBD. Cholecystectomy, performed in 12 of these individuals, revealed histopathologic changes of different degree in 11 and adhesions of the gallbladder to adjacent organs in 8. The method is simple to perform, cheap, has no side effects and gives a low rate of false positive diagnoses.