Perrillo R P, Zuckerman G R, Koehler R, Stanley R J
Am J Dig Dis. 1978 Sep;23(9):829-32. doi: 10.1007/BF01079793.
Thirty-two patients with chronic renal insufficiency (CRI) had oral cholecystography. Eleven of 15 patients (73%) with moderately advanced renal impairment had diagnostically inadequate single-dose cholecystograms. In contrast, all 11 patients on chronic hemodialysis had diagnostically opacified gallbladders following a single dose of contrast. Six other patients had biliary disease, either calculi (5 patients) or neoplasia (1 patient). These data suggest that CRI diminishes the likelihood of diagnostic gallbladder opacification, even in the absence of gallbladder disease, and that if the metabolic consequences of CRI are controlled by dialysis, the chances of diagnostic opacification are significantly improved (P less than 0.005). As oral cholecystography may not only result in inadequate opacification, but also carry the potential of renal toxicity, abdominal ultrasound should prove a safer and possibly more effective alternative in such patients.
32例慢性肾功能不全（CRI）患者接受了口服胆囊造影。15例中度肾功能损害患者中有11例（73%）单剂量胆囊造影诊断不充分。相比之下，11例接受慢性血液透析的患者在单剂量造影剂后胆囊均显影。另外6例患者患有胆道疾病，其中5例为结石，1例为肿瘤。这些数据表明，即使在没有胆囊疾病的情况下，CRI也会降低胆囊造影诊断的可能性，并且如果通过透析控制CRI的代谢后果，诊断性显影的机会会显著提高（P<0.005）。由于口服胆囊造影不仅可能导致显影不充分，还可能具有肾毒性，腹部超声在这类患者中应是一种更安全且可能更有效的替代方法。
