Oral cholecystography is a radiographic examination of the gallbladder using oral contrast media. It was developed in 1924 but has now been largely replaced by ultrasound and MRCP. The exam involves patients consuming contrast media 14 hours prior to imaging. Radiographs are taken in various positions including before and after a fatty meal to visualize the gallbladder and assess for any abnormalities like inflammation, polyps, tumors or gallstones. Precautions must be taken to minimize radiation exposure to the patient and staff during the exam.

1. By, Akash Das
Student Code- BWU/BRI/19/005
Paper Code- BMRIT-305
Oral Cholecystography
(OCG)

2. • Definition:
Oral Cholecystography or Oral Cholecystogram is the
radiographic study of gallbladder by the oral administration
contrast media.
Oral Cholecystography (OCG)
• It was developed in 1924 by
American surgeons E.A
Graham & W. H Cole.
• But now days it is largely
superseded by ultrasound
and MRCP.
• This is the initial examination for the investigation of
biliary tract.
Fig- 1: Gallbladder

3. • Inflammation of the organ.
• Other abnormalities like polyps.
• Tumors
• Gallstones
• To visualizing cystic duct and common bile.
• To demonstrate suspected pathology in the
gallbladder.
Fig- 3: Gallstone Formation
Fig- 2: Polyp Inside Gallbladder

4. • Pr severe hepatorenal disease.
• Acute cholecysititis
• Iodine sensitivity
• Pregnancy
• Dehydration
• An IV cholecystography within the previous week
evious cholecystectomy.
Fig- 4: Acute Cholecysititis Fig- 5: Pregnancy

5. • Patient should take low residue diet
for 2 days prior to examination.
• A laxative 2 days prior to the
examination.
• The CM is taken with water 14 hours
prior to the examination.
• A fat-containing meal after
preliminary film, if the gallbladder is
not visualize by contrast media.
• Food is forbidden until the
examination is completed.
Fig-6: Gall Stone Formation
Fig-7: Radiographic Appearance of GB

6. 1. Biloptin 2. Telepaque
3. Cholebrin 4. Solu-Biloptin
1. Prone 20º LAO
2. Supine 20º RPO
3. Erect 20º LAO
4. Fatty meal provided.
• Prone 20º LAO 30 minutes
after a fatty meal. Fig- 9: Positioning of patient for OCG
Fig- 8: Biloptin Capsules

7. • A night before the examination 6 tablet of Teleopaque or
Biloptin is given orally.
• After 12-16 hours a prone oblique view with right side
raised to 20º is taken for gallbladder visualization.
• After the preliminary film taken, the patient lie in the supine
position and appropriate spot film of the gallbladder are
taken.
• Ask the patient to eat fatty meal.
• After 30-40 min. films are taken to assess the contractibility
of the gallbladder and small filling defect. (stones or
polpyps)
• Cystic and common bile duct also visualized in post fatty
meal films.
* If the GB not visualized a "double dose" OCG may have to be
performed where the patient takes in all 12 tablets of CM.

8. • Mild gastrointestinal disturbances
• Skin reactions
• Uricosuric action
• Impaired renal function
• Psedoalbuminuria
• Abnormal thyroid function tests
• Increased effect of protein-bound drugs
because of shared binding with albumen
Fig- 11: Gastrointestinal Disturbances
Fig- 10: Skin Reactions

9. There are many ways by which
we can protect our self from
scattered radiation, like-
 By using
• Protective apron:0.5mmPb
• Lead shield:0.5mm Pb
• Lead protective gloves.
• Film badge or TLD monitor.
 And also we should always
the rule of TDS & ALARA
principle
 We can also use beam
limiting devices like cone to
minimize the radiation dose. Fig- 14: Beam Limiting Device (Cone)
Fig- 13: Cardinal’s principle (TDS)
Fig- 12: Lead apron, shield, gloves & TLD

10. THANK YOU