[Radiographically negative gallbladder--a surgically controlled study].

If the biliary tract is well seen, but the gallbladder remains unvisualized, one may conclude an obstruction of the gallbladder duct. The author shows by means of 108 cases, confirmed by surgery, that operation is indicated if the duct of the gallbladder is obstructed: Although mechanical obstruction of the cystic duct with a calculus was seen in only 10 cases (9,2%) at the time of operation, calculi were found in 101 patients (93%) in the biliary tract system, presenting with cholecystitis and mucosal oedema. In 103 patients (95,4%), the pathological findings had its origin in the biliary tract itself, in 5 cases (4,6%) the pathology was located in the surrounding area and affected the bile system. False-positive findings did not occur in any patient. Hence, the sensitivity that the biliary system is diseased if the cholangiogram is positive and the colecystogram is negative, was practically 100%. Finally, the author discusses the question why out of a total of 232 patients with X-ray finding of an obstruction of the gallbladder duct, the patients of the Surgical Clinics were operated with an incidence of 94%, whereas patients who had been transferred to us by Internal Medicine Clinics were operated with an incidence of 18%.