Study on cases of nonvisualized cholecystogram by the use of ERCP.

We used Endoscopic Retrograde Cholangiopancreatography (ERCP) in 77 patient in whom oral cholecystography failed to visualize the gallbladder. ERCP did not visualize the gallbladder in 42%, and poorly visualized it in 58%, however, there was no significant difference in the disease distribution between non- and poorly visualized cases. 63 of the 77 patients underwent surgery. In cases postoperatively diagnosed as gallbladder carcinoma, the prognosis was better in poorly than in non-visualized gallbladder cases. Non- or poor visualization by ERCP in operated cases was due to gallstones in 71%, to common duct stones with intrahepatic calculi in 22%, and to malignant tumors in 17.5%. Our findings suggest that non-visualization of the gallbladder by ERCP should alert the diagnostician to the possibility of malignancy, especially in patients over 50 years of age.