COMPARISON OF ORAL CHOLECYSTOGRAPHY AND ULTRASONOGRAPHY FOR EVALUATING CHRONIC CHOLECYSTITIS USING PATIENT OUTCOME AS THE REFERENCE-STANDARD

RATIONALE AND OBJECTIVES. The authors compared oral cholecystography ( OCG) with ultrasound (US) in the detection of chronic gallbladder dise ase using clinical outcome, rather than pathology results, as the refe rence standard. METHODS. The authors interviewed 269 patients who unde rwent either OCG, US, or both, for evaluation of chronic right upper q uadrant abdominal pain. The authors considered patients who underwent cholecystectomy with improved symptoms 1 to 4 years after surgery to b e reference-standard positive for gallbladder disease, and patients wi th objective evidence of an alternative diagnosis (eg, peptic ulcer di sease), which improved with therapy as reference-standard negative. RE SULTS. The sensitivity and specificity of OCG were 83% and 97%, respec tively, and for US, 86% and 90%, respectively. CONCLUSIONS. OCG is com parable with US in evaluating of chronic gallbladder disease. In insti tutions where OCG is used for diagnosing chronic cholecystitis, it may be reasonable to continue using OCG.