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August 12, 1974

Cholecystokinin Cholangiography

Author Affiliations

University of Iowa Hospitals and Clinics Iowa City

JAMA. 1974;229(7):764. doi:10.1001/jama.1974.03230450014006

To the Editor.—  We congratulate Dr. Dunn and his colleagues on their excellent article (228:997, 1974) and wish to make the following comments.Patients with recurrent biliary-like pain and repeatedly normal oral cholecystograms offer difficult clinical problems. They frequently undergo prolonged and expensive investigations and usually are labeled with the diagnosis of anxiety neurosis or the irritable bowel syndrome. Cholecystectomy is performed because of repeated attacks that interfere with the patient's life-style, yet one third of these patients who undergo operations will not be relieved of their symptoms.1 Therefore, there is a real need for a more sophisticated method of studying the patient with recurrent right upper quadrant pain and normal oral cholecystograms.Cholecystokinin cholangiography, in the experience of many authors, has successfully determined which patients should and should not have surgery,2-5 and, in our experience, has reduced the number of patients who return with recurrent pain to practically