Radiology, Vol 160, 27-28, Copyright © 1986 by Radiological Society of North America
Cholelithiasis in the morbidly obese: diagnosis by US and oral cholecystography
WC Klingensmith 3d and GV Eckhout
Forty-two morbidly obese patients underwent cholecystectomy at the time of
gastroplasty, primarily for prophylactic reasons. Preoperatively, 37
patients underwent ultrasonography (US) of the gallbladder and oral
cholecystography, four US only, and one oral cholecystography only. There
was one indeterminate US study (2.4%) and one indeterminate oral
cholecystogram (2.7%). At US study, gallstones were detected in six of the
eight patients with gallstones (sensitivity = 75%), and the gallbladders of
all 32 patients without gallstones were categorized as normal (specificity
= 100%). The gallstones not identified measured 1-2 mm in diameter. Oral
cholecystographic study enabled detection of gallstones in three of the
seven patients with gallstones (sensitivity = 43%) and categorized as
normal all 30 gallbladders without gallstones (specificity = 100%). The
gallstones not seen were small and included those not detected by US. The
results suggest that US is equal or superior to oral cholecystography for
detection of cholelithiasis in obese patients.
