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Gallbladder image density at oral cholecystography has been compared with histological grading of the severity of chronic cholecystitis in resulting cholecystectomy specimens. (i) There was a linear relationship between gallbladder opacification and the grade of chronic cholecystitis. (ii) Removal of patients with either non-opacified gallbladders or abnormal liver function did not alter the linear trend. (iii) The occurrence of gallstones was independent of the degree of gallbladder opacification. (iv) The presence of gallstones did not correlate with the severity of chronic cholecystitis. A standardised oral cholecystographic technique with a grading system for gallbladder image density can be used as an index of the severity of chronic cholecystitis.

Iocetamic acid (Cholebrin) and calcium ipodate (Solubiloptin) were randomly allocated to two groups of 50 patients. Each patient completed a detailed questionnaire for side effects. There was no significant difference between the contrast media in their ability to opacify the gallbladder. Cholebrin was superior to Solubiloptin in opacifying the common bile duct in the presence of abnormal liver function, but there was no difference when liver function was normal. Palpitations were significantly higher with Solubiloptin (P = 0.01) but the incidences of other side effects showed no significant differences. Unabsorbed contrast residues were noted in similar frequency with both media. A high incidence of chronic cholecystitis was found in patients with non-opacified gallbladders and in those with gallstones.