In the last decade, it has been found that cholecystography is the most important single objective aid in the diagnosis of dysfunction or disease of the gallbladder, yet neither the evaluation nor the technique of this procedure has become standardized. Early in the development of this test, Nichols, after a consideration of certain fundamental principles, adopted a procedure which has stood the test, of time, i. e., the oral method of administration of the dye combined with roentgen examination of the entire gastro-intestinal tract, which often is preceded by an examination of the urinary tract. These same procedures are used today—10 years later—and in the patients who have had operations at the Cleveland Clinic during the past five years, this procedure has proved accurate, whether in a positive or negative way, in 95 percent of the cases. The purpose of this brief discussion is to present the features of this examination, which in our experience have been of the greatest value.
There have been countless discussions relative to the merits of the intravenous versus the oral method of administration of the dye, and now that the oral method has been adopted generally, the current discussions center on the merits of the single versus the double or fractional dose method of administration.
Formerly, importance was attached to the time required for the gallbladder to fill and empty after administration of the dye. Now, Stewart and Illick1 report that their best visualization of the gallbladder is on the film made. . .