An oral cholecystogram is used in the investigation of gallbladder function. It also may incidentally reveal stones.
A control plain film is taken of the biliary area. This may show stones as 10% are radiopaque. Contrast is given by mouth 12 hours before further films are taken, during which time the normal patient will absorb, conjugate and secrete the contrast into the bile in the same way as bilirubin. Thus, this investigation requires patient compliance with the taking of contrast, a normal liver function, healthy gut absorption, a patent cystic duct, and gallbladder concentration of the contrast medium.
This investigation is superceded by abdominal ultrasound as a first line investigation in most centres. A positive oral cholecystogram - i.e. non-opacification - does not necessarily mean that there is a stone impacted in Hartmann's pouch, or that chronic cholecystitis is present. It is wise to repeat the examination with a double dose of contrast medium.
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