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PubMedDate not supplied

Effect of long-acting somatostatin analogue (octreotide, SMS 201-995) plus calcium channel blocker (verapamil) on gallbladder contraction.

BACKGROUND/AIMS: In this study we investigated the effect of the long-acting somatostatin analog octreotide (SMS 201-995) plus calcium channel blocker (Verapamil) on gallbladder contraction. METHODOLOGY: Fourty healthy volunteers participated in this study. Gallbladder volumes were measured by ultrasonography. After recording the baseline measurement, the volunteers received either saline (n:10), or SMS 201-995 100 B microgram subcutaneously (s.c.) (n:10) or verapamil 80 mg peroral (po) (n:10), or verapamil plus SMS 201-995 (n:10). Two hours later the gallbladder volumes were rescanned in 15 min intervals for 60 min. At the end all volunteers received standard liquid test meal (ensure 250 Cal/250 ml) and scans were again performed for one hour. RESULTS: The mean baseline gallbladder volume was 18.6 +/- 5.2 ml in all groups. The gallbladder volumes in the placebo group were 18.6 +/- 5.2 to 19.0 +/- 10.2 ml. In this group, after administration of test meal decreased the mean gallbladder volume to 14.3 +/- 7.5 to 8.4 +/- 5.8 ml, but these values were not significantly different from the baseline values. In the verapamil group the volumes increased from 18.6 +/- 5.2 to 28.5 +/- 9.7 to 30.8 +/- 11.6 ml. These values were significantly different from the baseline and the control group (p < 0.05). In this group, post-prandial mean volumes decreased to baseline in 30 min, but these values were higher than in the placebo group (p < 0.01). Verapamil-induced fasting the gallbladder relaxation was totally abolished to the placebo value by SMS 201-995. In verapamil plus SMS 201-995 and SMS 201-995 alone groups, the fasting and post-prandial volumes did not change when compared to the baseline value, but post-prandial volumes were higher than the placebo (p < 0.01). CONCLUSION: These results suggest that verapamil-induced gallbladder relaxation was totally abolished by SMS 201-995.

Adult↗

PubMed1998

Porcelain gallbladder associated with primary biliary adenocarcinoma in a dog.

A 9-year-old spayed female Poodle was admitted because of vomiting of 3 weeks' duration, lethargy, and anorexia. Palpation of the cranial portion of the abdomen elicited signs of pain. Principal laboratory abnormalities included mild segmented neutrophilia, lymphopenia, high serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase activities, and hyperbilirubinemia. Radiography revealed foamy appearing areas of mineral opacity in the region of the gallbladder. Ultrasonographically, a hyperechoic structure with acoustic shadowing was seen in the same region, and extrahepatic bile ducts were distended. Cholecystectomy was performed. The gallbladder wall felt thicker than normal and was bluish-white. Multiple choleliths were found in the gallbladder and extrahepatic bile ducts. Histologic examination revealed chronic proliferative lymphoplasmacytic cholecystitis with mineralization and a well-differentiated adenocarcinoma of the gallbladder neck. A diagnosis of porcelain gallbladder was made. The dog recovered without complications and was healthy 14 months after surgery. To our knowledge, porcelain gallbladder has not been reported in dogs. In human patients, it is defined as intramural mineralization of the gallbladder commonly associated with gallbladder neoplasia. Early recognition is important for appropriate surgical treatment.

Adenocarcinoma↗

PubMed1996

Simultaneous bacteriologic assessment of bile from gallbladder and common bile duct in control subjects and patients with gallstones and common duct stones.

OBJECTIVES: To determine the simultaneous prevalence of bacteria in bile from the gallbladder and common bile duct and to determine the influence of the number of stones present on bacteriologic findings. METHODS: A prospective study was performed in 467 subjects divided into seven groups: 42 control subjects with normal biliary tracts, 221 patients with symptomatic gallstone disease, 12 patients with hydropic gallbladder, 52 patients with acute cholecystitis, 67 patients with common bile duct stones without cholangitis, 49 patients with common bile duct stones and acute cholangitis, and 24 patients with previous cholecystectomy and common bile duct stones. In all except controls, bile samples from the gallbladder and common bile duct were taken simultaneously for aerobic and anaerobic cultures. RESULTS: Control subjects had no bacteria in gallbladder bile. Patients with gallstones, acute cholecystitis, and hydropic gallbladder had similar rates of positive cultures in the gallbladder and common bile duct, ranging from 22% to 46%, but the rate was significantly higher in patients with common bile duct stones without cholangitis (58.2%). Patients with cholangitis or previous cholecystectomy had a high rate of positive cultures of common duct bile (93% to 100%). Age greater than 60 years had a significant influence on the rate of positive bile cultures. There was no relationship between the number of stones in the gallbladder or common bile duct and the percentage of positive cultures. In 98% of the patients, the same bacteria were isolated from gallbladder and common duct bile. CONCLUSIONS: In normal subjects, no bacteria were present in the biliary tract. Among patients with common bile duct stones, there was an increasing percentage of positive cultures according to the severity of the disease. Age had an important influence, but sex and the number of common bile duct stones had no influence on positive cultures.

Acute Disease↗

PubMed1987

Effect of vagal denervation on canine gallbladder motility.

There is an increased incidence of gallstones after truncal vagotomy but the mechanism is unknown. Our aim was to study the early effects of vagotomy on fasting and postprandial gallbladder motility. A chronic model was constructed in 10 dogs to correlate gallbladder motility and emptying with interdigestive and postprandial duodenal motility both before and after selective hepatobiliary vagotomy (five dogs) and truncal vagotomy (5 dogs). During each study recordings were made for one complete interdigestive motor complex (IDMC) and for 90 min after a standard meal of (a) gallbladder and duodenal motility, (b) gallbladder emptying (by a dual radioisotope marker technique) and (c) duodenal output of bilirubin. In control studies the gallbladder contracted at the start of phase II of the interdigestive motor complex and ejected 20-25 per cent of its contents into the duodenum; after meals the gallbladder contracted within 5 min and emptied almost 80 per cent of its contents within 90 min. After both selective hepatobiliary vagotomy and also truncal vagotomy there was no significant difference in the pattern of contraction or emptying of the gallbladder either during fasting or postprandially. We conclude that gallbladder motility and emptying are entirely normal in the early period after vagal denervation.

Animals↗

PubMed1992

Cholesterol metabolism in human gallbladder mucosa: relationship to cholesterol gallstone disease and effects of chenodeoxycholic acid and ursodeoxycholic acid treatment.

The objective of this study was to investigate cholesterol metabolism in human gallbladder mucosa, especially in relation to hepatic cholesterol metabolism, gallstone disease and treatment with bile acids. Gallbladder mucosa and liver tissue samples were collected in 44 patients undergoing cholecystectomy; 30 had cholesterol gallstones and the rest were stone free. Ten of the gallstone patients were treated with chenodeoxycholic acid and eight received ursodeoxycholic acid, with a daily dose of 15 mg/kg body wt, for 3 wk before surgery. The 3-hydroxy-3-methylglutaryl coenzyme A reductase activity, governing cholesterol synthesis, was considerably lower in the gallbladder mucosa than in liver tissue (28 +/- 6 and 120 +/- 40 pmol/min/mg protein). The acyl coenzyme A:acyltransferase activity in the gallbladder mucosa catalyzing the esterification of cholesterol was, on the other hand, several times higher than corresponding activity in the liver (92 +/- 23 and 11 +/- 2 pmol/min/mg protein). In the presence of exogenous cholesterol, the acyl coenzyme A:acyltransferase activity increased about twofold in the gallbladder mucosa. The acyl coenzyme A:acyltransferase activity of the gallbladder mucosa from untreated gallstone patients was not stimulated further by the addition of exogenous cholesterol. Otherwise, there were no significant differences in acyl coenzyme A:acyltransferase and 3-hydroxy-3-methylglutaryl coenzyme A reductase activities in the gallbladder mucosa of gallstone patients compared with gallstone-free controls. Treatment with chenodeoxycholic and ursodeoxycholic acids did not affect the 3-hydroxy-3-methylglutaryl coenzyme A reductase activity of the gallbladder mucosa but reduced the acyl coenzyme A:acyltransferase activity by 60% to 65%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Effect of loxiglumide and atropine on erythromycin-induced reduction in gallbladder volume in human subjects.

This study was undertaken to investigate the effect of erythromycin, a motilin agonist with prokinetic activity, on fasting gallbladder volume. To evaluate the mechanism of action of erythromycin on gallbladder motility, erythromycin (3.5 mg/kg.20 min, intravenously) was infused on three separate occasions: during cholinergic blockage with atropine (0.005 mg/kg.hr), during cholecystokinin receptor blockade with loxiglumide (10 mg/kg.hr) and during saline solution infusion (control). Atropine, loxiglumide and saline solution infusions were started 3 hr before administration of erythromycin and were continued for 3 hr thereafter. Gallbladder volumes (measured by ultrasonography), plasma cholecystokinin levels (radioimmunoassay) and plasma pancreatic polypeptide levels (radioimmunoassay) were determined at regular intervals for 6 hr in six healthy volunteers. During the 3-hr infusion before administration of erythromycin, both loxiglumide and atropine significantly increased gallbladder volumes--from 18 +/- 2 to 37 +/- 3 cm3 (p less than 0.05) and from 17 +/- 3 to 24 +/- 2 cm3 (p less than 0.05), respectively--whereas saline solution did not significantly affect gallbladder volume. During control saline solution infusion, erythromycin induced prolonged gallbladder contraction that was significant (p less than 0.05) between 60 and 180 min and reached a maximum of 45% +/- 8% at 150 min. Plasma cholecystokinin levels were not affected by erythromycin. Erythromycin induced a significant (p less than 0.05) increase in plasma pancreatic polypeptide levels, from 12 +/- 1 pmol/L to 34 +/- 3 pmol/L. Loxiglumide did not prevent the erythromycin-induced reduction in gallbladder volume. Atropine markedly reduced the effect of erythromycin, causing slight but significant (p less than 0.05) gallbladder volume reductions (18% +/- 4%) between 150 and 180 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Acute effects of topical methyl tert-butyl ether or ethyl propionate on gallbladder histology in animals: a comparison of two solvents for contact dissolution of cholesterol gallstones.

Experiments were performed in anesthetized rabbits and piglets to assess gallbladder mucosal injury during irrigation with methyl tert-butyl ether, a C5 ether, or ethyl propionate, a C5 ester--two organic solvents used in the contact dissolution of cholesterol gallstones. In 44 New Zealand White rabbits, the gallbladder was exposed to individual solvents or saline solution through a transhepatic catheter for 2 hr. Gallbladders were then harvested and fixed immediately or after a recovery period of 1, 4 or 8 days. Tissue sections were examined under light microscopy, and severity of injury was graded with predefined criteria by two pathologists blinded to the animals' treatment regimens. Histological assessment showed severe mucosal injury such as necrosis of the cells at the villus tips immediately after 2 hr of exposure to either solvent. After 4 days, injury had decreased significantly; after 8 days, complete mucosal healing had taken place. A similar study was performed in 32 piglets. Solvent or saline solution was oscillated in and out of the gallbladders of these piglets with a computer-controlled syringe pump at a pressure less than the leakage pressure of the gallbladder. Histological assessment was performed on tissue samples obtained immediately after the procedure or 8 days later. Both solvents caused severe mucosal injury; however, after 8 days complete mucosal healing had occurred, so that gallbladders exposed to solvent were indistinguishable from gallbladders exposed to saline solution, which was used as control. We conclude that both methyl tert-butyl ether and ethyl propionate cause moderate to severe epithelial injury but that the gallbladder epithelium regenerates within a few days.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2006

Gallbladder cancer worldwide: geographical distribution and risk factors.

Gallbladder cancer is a relatively rare neoplasm that shows, however, high incidence rates in certain world populations. The interplay of genetic susceptibility, lifestyle factors and infections in gallbladder carcinogenesis is still poorly understood. Age-adjusted rates were calculated by cancer registry-based data. Epidemiological studies on gallbladder cancer were selected through searches of literature, and relative risks were abstracted for major risk factors. The highest gallbladder cancer incidence rates worldwide were reported for women in Delhi, India (21.5/100,000), South Karachi, Pakistan (13.8/100,000) and Quito, Ecuador (12.9/100,000). High incidence was found in Korea and Japan and some central and eastern European countries. Female-to-male incidence ratios were generally around 3, but ranged from 1 in Far East Asia to over 5 in Spain and Colombia. History of gallstones was the strongest risk factor for gallbladder cancer, with a pooled relative risk (RR) of 4.9 [95% confidence interval (CI): 3.3-7.4]. Consistent associations were also present with obesity, multiparity and chronic infections like Salmonella typhi and S. paratyphi [pooled RR 4.8 (95% CI: 1.4-17.3)] and Helicobacter bilis and H. pylori [pooled RR 4.3 (95% CI: 2.1-8.8)]. Differences in incidence ratios point to variations in gallbladder cancer aetiology in different populations. Diagnosis of gallstones and removal of gallbladder currently represent the keystone to gallbladder cancer prevention, but interventions able to prevent obesity, cholecystitis and gallstone formation should be assessed.

Adult↗

PubMed1992

Risk factors for gallbladder cancer: a Polish case-control study.

A population-based case-control study of gallbladder cancer was conducted in the south-west of Poland, within the frame-work of the SEARCH Programme of the International Agency for Research on Cancer. A total of 73 cases and 186 controls were interviewed using a questionnaire including demographic and socio-economic factors, education, smoking, alcohol, tea and coffee consumption, and past medical history. A validated diet history was used to estimate the daily intake of calories, fats, carbohydrates, proteins, cholesterol, fibres and vitamins C and E. Gallbladder disease was the major determinant of subsequent gallbladder cancer: 41 cases (56%) vs. 15 (8%) controls had a past history of gallbladder disease, corresponding to an odds ratio (OR) of 12.5 (95% confidence interval, 5.8 to 26.6), and the OR was 12.1 for gallbladder problems dating back 20 years or more in the past. There was an inverse relationship with education, the OR being 0.3 (95% CI 0.1 to 1.2) for 13 years of education or more vs. less than 7. Gallbladder cancer risk was positively associated with total calorie intake, with ORs of 1.4, 1.5, 4.1 for the 3 upper quartiles compared with the lowest one (trend, p less than 0.01). Weaker direct associations were observed for proteins, carbohydrates and cholesterol. There was some suggestion of inverse associations with fibre intake, and a more consistent one with vitamins C and E. These results further quantify the role of gallstones, and suggest that total calorie intake and other dietary factors potentially linked with benign gallbladder conditions are involved in the aetiology of gallbladder cancer.

Adult↗

PubMed1996

Intraabdominal contamination after gallbladder perforation during laparoscopic cholecystectomy and its complications.

BACKGROUND: Gallbladder perforation often occurs during laparoscopic cholecystectomy. METHODS: The frequency and causes of gallbladder perforation as well as the relevant clinical background factors were investigated in 110 patients undergoing laparoscopic cholecystectomy. We also evaluated intraperitoneal contamination by bacteria and gallstones at the time of gallbladder perforation and investigated whether perforation caused early or late postoperative complications. RESULTS: Intraoperative gallbladder perforation occurred in 29 of the 110 patients (26.3%). It was caused by injury with an electric knife during dissection of the gallbladder bed, injury during gallbladder retraction with grasping forceps, injury during gallbladder extraction from the abdomen, and slippage of cystic duct clips (potentially causing bile and stone spillage). Perforation was more frequent in patients with positive bile cultures and in those with pigment stones (p < 0.02), but not in patients with cholecystitis or cystic duct obstruction. The peritoneal cavity was contaminated by bacteria in 11/29 patients (37.9%) and by spilled stones in 3/29 patients (10.3%). There was no difference in the incidence of postoperative complications between the patients with and without perforation either in the early postoperative period or during follow-up for 24-42 months. Only one patient developed abdominal pain and fever in the early postoperative period, and they were probably related to perforation. CONCLUSIONS: Although gallbladder perforation is sometimes unavoidable during laparoscopic cholecystectomy, the risk of severe complications appears to be minimized by early closure of perforation, retrieval of as many of the spilled stones as possible, and intraperitoneal lavage.

Cholecystectomy, Laparoscopic↗

PubMed1995

Effects of somatostatin and loxiglumide on gallbladder motility.

Cholecystokinin (CCK) is the major hormonal stimulus of gallbladder contraction. Both somatostatin and CCK-A receptor antagonists inhibit stimulation of the gallbladder by CCK. The aim of this study was to compare the effect of somatostatin and the CCK-A receptor antagonist loxiglumide (CR 1505) on gallbladder volume at baseline and after feeding. In random order nine healthy subjects received somatostatin (IV loading dose 125 micrograms, followed by IV infusion of 125 micrograms.h-1), loxiglumide (10 mg.kg-1.h-1) and control saline. Gallbladder volumes and plasma CCK levels were measured basally and during stimulation by an intraduodenal infusion of fat using, respectively, ultrasound and a sensitive and specific radioimmunoassay. Mean basal gallbladder volume was similar prior to the saline control (28.5 ml), loxiglumide (28.7 ml) and somatostatin (23.4 ml) experiments. In the control experiment, intraduodenal fat led to a significant increase in plasma CCK from 2.6 to 4.8 pmol.1-1, accompanied by contraction of the gallbladder to 2.0 ml. Loxiglumide induced dilatation of the gallbladder to 40 ml and prevented the any contraction in response to intraduodenal fat. During the somatostatin infusion, gallbladder volume remained the same both basally and during fat stimulation. The plasma CCK response to intraduodenal fat was exaggerated by loxiglumide and was abolished by somatostatin.

Adult↗

PubMed1983

Automated calculation of gallbladder ejection fraction.

We have developed a computer method which by automatically locating the border of the gallbladder in each image and subtracting a varying location-dependent background corresponding to the gallbladder border overcomes the difficulties associated with quantitating gallbladder contraction. These difficulties are attributable to significant and changing background activity, imprecise manual delineation of the gallbladder, and the changing position and shape of the gallbladder. Validation studies using a gallbladder phantom showed the method to be very accurate. No significant difference (P greater than 0.05) was observed between the expected and calculated ejection fractions. Ten patient studies were analyzed, with a resulting range of gallbladder ejection fractions of 22-79%. Excellent reproducibility was obtained with an average intraobserver coefficient of variation of 3.5%, and no statistically significant difference in interobserver measurements (P greater than 0.05). The regression line for interobserver measurements had a slope of 0.96 +/- 0.08, an intercept of 1.6 +/- 4.0%, and a correlation coefficient of 0.99. From these preliminary results we conclude that this method offers a reliable means of quantitating gallbladder contraction.

Cholecystokinin↗

PubMed1994

Effect of hyperglycaemia on gallbladder motility in type 1 (insulin-dependent) diabetes mellitus.

Patients with diabetes mellitus are at increased risk of developing gallstones. This has been attributed, among other factors, to alterations in gallbladder motility in the presence of autonomic neuropathy. Since high blood glucose concentrations impair gastric emptying in diabetic patients, we have investigated the effect of acute hyperglycaemia on gallbladder motility. Seven Type 1 (insulin-dependent) diabetic patients were studied twice during euglycaemia (blood glucose 5 mmol/l) and hyperglycaemia (blood glucose 15 mmol/l) using a clamp technique. In addition, seven healthy volunteers were studied during euglycaemia and hyperglycaemia. Gallbladder volumes, measured with ultrasonography, were studied before and during infusion of step-wise increasing doses of cholecystokinin-33, 0.25, 0.5 and 1.0 Ivy Dog Unit.kg-1.h-1, each dose for 30 min. Mean basal gallbladder volumes were not significantly different in the four experiments. Administration of cholecystokinin resulted in significant (p < 0.05) dose-dependent reductions in gallbladder volume in all experiments. During euglycaemia the gallbladder contraction in diabetic patients was not significantly different from the control subjects. During hyperglycaemia the gallbladder contraction in the diabetic patients was significantly (p < 0.05) reduced compared to euglycaemia only during infusion of 0.25 Ivy Dog Unit.kg-1.h-1 of cholecystokinin (19 +/- 6% vs 33 +/- 6%). Compared to euglycaemia, during hyperglycaemia the gallbladder contraction in the control subjects was significantly (p < 0.05) reduced during infusion of 0.25, 0.5 and 1.0 Ivy Dog Unit.kg-1.h-1 of cholecystokinin (14 +/- 4% vs 31 +/- 3%; 42 +/- 6% vs 65 +/- 5%; 74 +/- 4% vs 90 +/- 3%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

Loperamide inhibits gallbladder inflammatory fluid secretion in experimental cholecystitis.

Fluid secretion by the gallbladder mucosa is suggested to have a key pathophysiological role in acute cholecystitis, since it causes distension of the obstructed gallbladder. The present study investigates the actions of loperamide on the gallbladder function in experimental cholecystitis. Gallbladder fluid transport and motility were studied in vivo with a continuous perfusion technique. A net fluid secretion by the gallbladder mucosa was seen in cats in which cholecystitis was induced whereas there was a net fluid absorption from the gallbladder lumen in the control animals. The net fluid secretion in experimental cholecystitis was inhibited by loperamide (1 mg/kg), an effect that was blocked by naloxone (1 mg/kg), suggesting an involvement of specific opiate receptors. Loperamide (1 mg/kg) relaxed the normal gallbladder but had no significant effects on its fluid absorption. Since loperamide reduces mucosal fluid secretion in experimental cholecystitis without contracting the gallbladder wall, it is suggested that this peripherally acting opiate agonist could be useful in the treatment of patients with acute cholecystitis.

Animals↗

PubMed1988

Gastric phenotypic expression in human gallbladder cancers revealed by pepsinogen immunohistochemistry and mucin histochemistry.

Gastric phenotypic expression indicated by paradoxical concanavalin A (Con A) staining for class III mucins and the immunoperoxidase method for pepsinogen (Pg) I and Pg II was found in pyloric gland metaplasia of gallbladder epithelium. Using the same methods, the features of gallbladder cancers and their relationship to pyloric gland metaplasia in the human gallbladder epithelium were studied. Histologically, 57 gallbladder cancers were classified into 5 papillary adenocarcinomas, 29 tubular adenocarcinomas, 8 poorly differentiated adenocarcinomas, 6 signet-ring cell carcinomas, 4 mucinous adenocarcinomas, and 5 squamous cell carcinomas. In papillary and tubular adenocarcinomas, Pg I and/or Pg II staining was detected in 80% and 75.9% of cancers, respectively. Pg II staining was significantly more frequent than Pg I staining. One signetring cell carcinoma also had Pg II activity. Pyloric gland metaplasias all contained class II mucins and were further classified into complete type and incomplete type on the basis of presence or absence Pg I and/or Pg II activities. A few cancer cells with class III mucins were negative for Pg staining; conversely, a few cells with Pg I and/or Pg II had no class III mucins. Phenotypic diversity in both class II mucin reactivity and Pg activities was observed in gallbladder cancer cells with the pyloric gland cell type. By comparison, pyloric gland metaplasia varied only in Pg activities. A few Pg-positive cancers were found in the gallbladder with Pg-negative pyloric gland metaplasia. The present results clearly indicate the appearance of gastric phenotypic expression in both gallbladder epithelium and gallbladder cancers and suggest the independent induction of pyloric gland metaplasia and cancer with gastric phenotypic expression.

Adult↗

PubMedDate not supplied

Intrahepatic abscess due to gallbladder perforation.

BACKGROUND: Perforation of the gallbladder with cholecystohepatic communication is a rare cause of liver abscess. We report four cases of this condition and describe the imaging procedures related to its diagnosis and treatment. METHODS: The medical and x-ray files of 39 patients with percutaneous drainage of liver abscesses were retrospectively reviewed. Four patients with hepatic abscess due to gallbladder perforation were identified. The patients presented with clinical features suggestive of cholecystitis. RESULTS: Sonography in four patients showed a hypoechoic lesion in the liver adjacent to the gallbladder. CT in three patients showed a hypodense area in the liver, corresponding to the sonographic findings. Percutaneous abscess drainage, followed by an abscessogram, was performed in all patients. Contrast material injected through the drainage catheter filled the gallbladder directly from the abscess cavity. Two patients subsequently underwent cholecystectomy, confirming perforation of the gallbladder fundus. In both cases the gallbladder was noted to be embedded in the liver and covered by adhesions. CONCLUSION: Perforation of the gallbladder is a rare cause of pyogenic liver abscess. We suggest, however, based on our two patients who underwent surgery, and several cases reported in the literature, that this condition may be more common when the gallbladder is partially or totally intrahepatic.

Aged↗

PubMed1992

Effect of cholecystectomy on gallbladder bile composition.

Human bile samples are commonly used in biliary research; however, the optimal sampling technique is not known. The current study examines whether bile obtained prior to operative manipulation of the gallbladder differs in composition from samples obtained after cholecystectomy. Gallbladder bile samples were obtained from 26 patients undergoing cholecystectomy. An initial sample was obtained prior to manipulation or devascularization of the gallbladder, and a second sample was obtained after the removal of the gallbladder from the operative field. Gallbladder bile pH and total protein were significantly increased in the postcholecystectomy samples. Bile obtained after cholecystectomy also contained significantly less phospholipid. Gallbladder bile cholesterol, total bile acids, bilirubin, ionized and total calcium, cholesterol saturation index, and total lipids were similar between techniques. These results indicate that manipulation of the gallbladder during cholecystectomy produces alterations in gallbladder bile composition. These results also emphasize the need for consistent sampling technique when obtaining samples for biliary research.

Bile↗

PubMed1987

Effects of meal composition on gallbladder and gastric emptying in man.

Cholecystogastric scintigraphy, utilizing [99mTc]HlDA to label the gallbladder contents and [111In]DTPA to label different meals, was utilized to determine the relationships between gallbladder and gastric emptying after meals of differing composition. Gallbladder emptying was determined in response to a multicomponent meal and to monocomponent fat, carbohydrate, and protein meals and in response to isotonic and hypertonic dextrose and isotonic and hypertonic saline. Also, the gallbladder emptying responses to equivalent multicomponent solid and liquid meals were compared. Significant gallbladder emptying was observed in response to the multicomponent meal and the monocomponent fat, carbohydrate, and protein meals. The most rapid and complete gallbladder emptying was seen with the multicomponent meal and the monocomponent fat meal. Significant gallbladder emptying was stimulated, not only by isotonic and hypertonic dextrose, but also by hypertonic saline. The gallbladder emptied more rapidly after a liquid than after a solid meal.

Adult↗