Cholecystography With lopanoic Acid "Reinforcement" Before Initial Study

Abstract

An estimated 15 million Americans are afflicted with gallstones;¹the differential diagnosis of biliary tract disease is one of the major problems of adult clinical medicine. Oral cholecystography has long been the mainstay of roentgen evaluation, and iopanoic acid (Telepaque) has for many years been the agent most frequently used for this examination. More than 20 years of extensive clinical use has established the safety of this agent; administration of very large doses in the presence of severe hepatorenal disease appears to be the only specific contraindication. Since the initial report in 1959,²a number of studies have confirmed that gallbladder opacification sufficient for diagnosis is not obtained in 20% to 30% of patients administered iopanoic acid in the usual initial dose of 3 gm. When the initial dose results in total nonopacification of the gallbladder, reinforcement with a second dose of 3 gm results in a normal