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An Update in Radionuclide Imaging in the Diagnosis of Cholecystitis

Heidi S. Weissmann, MD; Ruth Rosenblatt, MD; Leroy A. Sugarman, MD; Leonard M. Freeman, MD
JAMA. 1981;246(12):1354-1357. doi:10.1001/jama.1981.03320120054032.
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THE RAPID and accurate diagnosis of biliary disease is an important medical problem. Sixteen million Americans are estimated to have gallstones, and they will develop in an additional 800,000 persons each year.1 Cholelithiasis and its complications are the fourth most common cause for surgical hospitalization and the most common indication for abdominal surgery in adults.2 More than 500,000 operations are performed annually for gallbladder disease at a cost of more than $1 billion.1,2

In view of the magnitude of the problem, it is not surprising that numerous diagnostic procedures have evolved for the evaluation of hepatobiliary disease, including oral cholecystography, intravenous cholangiography, ultrasonography, transhepatic cholangiography, computed tomography (CT), and endoscopic retrograde pancreaticoduodenography. Since more than 95% of cases of acute cholecystitis are associated with cystic duct obstruction, this finding is the major hallmark of the imaging diagnosis of acute inflammatory disease. The ideal method for diagnosing acute


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