Tyler Neitlich MD, Presenter: Nothing to Disclose

Jeffrey David Neitlich MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to compare CT cholecystography and ultrasound for gallstone detection in preoperative bariatric surgery patients.

The study included 16 asymptomatic pre-bariatric surgery patients. On the same day, each underwent abdominal CT four hours after IV cholecystograffin injection, and gallbladder ultrasound. CT and ultrasounds were reviewed by two independent, blinded radiologists, and scored as follows: No gallstones; possible gallstones; definite gallstones; indeterminate. CT and ultrasound results were compared.

Ultrasound detected definite gallstones in three, possible gallstones in one, and no gallstones in ten patients. Two were indeterminate. CT cholecystography detected definite gallstones in six, possible gallstones in zero, and no gallstones in nine patients. One was indeterminate. All three patients with gallstones seen sonographically had gallstones on CT. The patient with possible gallstones detected sonographically had definite stones on CT. One patient with an indeterminate ultrasound had gallstones on CT. The other indeterminate ultrasound also had an indeterminate CT. One patient with no gallstones sonographically had definite gallstones on CT. No patients with a negative CT had a positive ultrasound

CT cholecystography is more sensitive and specific for gallstone detection than ultrasound in the obese population. CT cholecystography should be considered prior to bariatric surgery.

CT cholecystography is a useful technique for detecting gallstones in patients undergoing bariatric surgery, who often have limited ultrasound exams because of poor sound beam penetration.

Neitlich, T, Neitlich, J, Comparison of CT Cholecystography and Ultrasound for the Detection of Gallstones in Patients Undergoing Bariatric Surgery.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5016394.html