Ultrasonography and oral cholecystography: a comparison of their use in the diagnosis of gallbladder disease.

The charts of all cholecystectomy patients at the White Memorial Medical Center, Los Angeles, from January 1977 to December 1979 were reviewed; of 374 patients, 76 had had both abdominal ultrasound scan and oral cholecystography performed preoperatively. Cholecystography accurately diagnosed gallbladder disease in 71 of these 76 patients, an accuracy rate of 93.4% with one false-positive and four false-negative results. Ultrasonography correctly predicted gallbladder disease in 66 of 76 patients, an accuracy rate of 86.8%, with one false-positive and nine false-negative results. On the basis of this study and others in the literature, ultrasound scanning is recommended as the initial screening diagnostic study for gallbladder disease. Oral cholecystography should follow in patients in whom ultrasonography fails to identify gallbladder calculi.