THE CLINICAL SIGNIFICANCE OF ULTRASONIC-GUIDED PUNCTURE CHOLECYSTOGRAPHY

Abstract

Ultrasonic-guided puncture cholecystography was performed in 54 cases with negative cholecystograms by intravenous cholangiography, ERCP or PTC, and the successful results were obtained in 46 cases. The puncture cholecystograms of patients witn gallbladder disease were classified into six types, and the method proved useful with benign/malignant differentiation being easy in 79% of the cases. However, the differentiation was difficult in Type D in which the neck of the gallbladder or the end of the cystic duct showed an obstruction with smooth margin.
Cytology of the bile aspirated at gallbladder puncture showed that all benign cases were negative, while positive findings were obtained in 5 out of 8 subjects with carcinoma of the gallbladder.
The concurrent use of cholecystography and cytology of the bile made a diagnosis of carcinoma of gallbladder possible in 7 of 8 cases. It is, therefore, considered that the two methods should be used together.