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PubMed1998

Effects of bombesin on the canine gallbladder motility: in vivo and in vitro experiments.

The effects of bombesin (BM) on the canine gallbladder motility was studied under two different experimental conditions: (i) in conscious dogs with a balloon chronically implanted into the gallbladder lumen where intragallbladder pressure was recorded in mm Hg by means of a pressure transducer, and (ii) in smooth muscle preparations isolated from different regions of the gallbladder where the contractions were recorded isometrically by means of mechanoelectrical transducers. Similar to CCK8 bolus injection of. BM i.v. increased the gallbladder pressure in a dose-dependent manner. The response was characterized by a slow increase of the tone and a gradual restoration (in 4 to 8 min) of the background activity. The threshold dose and the maximum dose were 30 ng/kg and 100 ng/kg for BM and 1 ng/kg and 10 ng/kg for CCK8, respectively. Both atropin (10 to 50 micrograms/kg) and hexamethonium (0.5 to 3 mg/kg) injected i.v. 5 to 10 min before BM strongly reduced or even abolished the gallbladder response to BM. Somatostatin (1 to 2 micrograms/kg) and VIP (0.5 to 1 microgram/kg) injected 3 to 5 min before BM also exerted a strong inhibitory effect on the canine gallbladder response to BM. However BM (up to 10(-6) M) had no effect on the spontaneous or electrically-induced contractions of the canine gallbladder smooth muscle preparations. The results suggest the involvement of prejunctional cholinergic-, somatostatinergic- and VIP-ergic pathways in the bombesin-induced increase of the gallbladder pressure of conscious dogs.

Acetylcholine↗

PubMedDate not supplied

A case of classical carcinoid tumor of the gallbladder: review of the Japanese published works.

A 58 year-old man was admitted to Kimitsu Chuo Hospital complaining of epigastralgia. Abdominal ultrasound and computed tomography revealed a polypoid lesion at the neck of the gallbladder. Given the pre-operative diagnosis of gallbladder carcinoma, we resected the gallbladder along with the extrahepatic bile duct. There was a papillary tumor (25 x 16 mm) at the neck of the gallbladder. Histopathological examinations showed a subserosal nodular proliferation of uniform small tumor cells. Grimelius staining was slightly positive and Fontana-Masson staining was negative. Most of the tumor cells stained positively for chromogranin A and neuron-specific enolase (NSE), and some of the tumor cells were positive for pancreatic polypeptide. The presence of neurosecretory intracytoplasmic granules was proven ultrastructurally. It was diagnosed as a classical carcinoid tumor of the gallbladder. We reviewed the Japanese reported cases and discussed the difference in clinicopathological findings between classical and atypical carcinoid tumors of the gallbladder. Classical carcinoids of the gallbladder have neither a metastatic nor invasive character, and an extremely favorable prognosis compared with atypical carcinoids. The difference in character between classical and atypical carcinoids of the gallbladder is thought to be derived from their histogenetic origin.

Carcinoid Tumor↗

PubMed1999

Plasma lipoproteins affect rate of cholesterol absorbed from bile by gallbladder: preliminary data.

BACKGROUND: The excessive accumulation of cholesterol absorbed from bile by the gallbladder impairs its contractility and favours gallstone formation. The total low plasma and high density lipoprotein cholesterol concentrations are associated with gallstone disease. AIMS: To investigate the effect of plasma lipoproteins on gallbladder cholesterol and phosphatidylcholine absorption from bile and to establish whether cholesterol absorption is Brefeldin A-sensitive. METHODS: Gallbladder mucosa lipid absorption rates were measured using: 1) in vitro isolated intra-arterially perfused pig gallbladder model with and without plasma lipoproteins perfusing the vascular tree; 2) human gallbladder fragments mounted in Ussing chambers with plasma lipoproteins at different concentrations in the serosal side; 3) pig gallbladder fragments mounted in Ussing chambers in the presence and absence of Brefeldin A. RESULTS: Total lipoproteins and high density lipoprotein significantly increased the release of biliary cholesterol and phosphatidylcholine in plasma and significantly decreased the tissue accumulation of cholesterol absorbed from bile. The scavenger effect of plasma lipoproteins on cholesterol absorbed from bile was concentration dependent. Brefeldin A did not influence gallbladder absorption of biliary cholesterol. CONCLUSIONS: Biliary cholesterol is absorbed by gallbladder mucosa via a Brefeldin-insensitive pathway and is removed by plasma lipoproteins.

Absorption↗

PubMedDate not supplied

Gallbladder carcinoma during laparoscopic cholecystectomy: is it associated with bad prognosis?

Laparoscopic cholecystectomy is the treatment of choice for gallstone disease. The ultrasonogram has failed for the early detection of gallbladder cancer, especially if inflammation (chronic or acute) is present. Incidental gallbladder could be an important cancer finding during laparoscopic cholecystectomy, due to the potential cancer cell dissemination during the procedure. In our Department, 6500 laparoscopic cholecystectomies have been performed in the last 5 years and in 15 cases (0.23%) gallbladder cancer was found during surgery or after histological examination of the resected gallbladder. In none of these 15 patients was pre-operative diagnosis of gallbladder carcinoma postulated. When re-evaluation of the pre-operative ultrasonograms was done, it was possible to observe signs suggesting the presence of neoplastic infiltration in 4 of them (28.6%). During videoscopic exploration, also in 4 patients, the suspicion of gallbladder cancer was noted. Laparoscopic cholecystectomy was completed in 9 patients. In 2 of them, in situ or mucosal invasion was demonstrated with a long survival. One patient presented recurrence at the biliary hilum 2,5 years after surgery. Six patients were re-operated and in 4 of them peritoneal or port site metastasis was found; all died early (4.5 month median survival). The other 2 patients were submitted to liver bed resection and lymph node dissection. These patients are free of cancer recurrence after 15 months of follow-up. Six patients were converted to open surgery, performing palliative procedures and died before the 12 month follow-up. The suspicion of pre-operative gallbladder cancer is generally unlikely to be confirmed based on ultrasonographic signs; but, in some cases with high suspicion, further investigation (TAC, tumor markers, etc.) must be indicated in order to avoid poor results. Laparoscopic cholecystectomy could be associated with bad prognosis, and then, when gallbladder cancer is suspected during the laparoscopic procedure, conversion to open surgery could be the best choice.

Carcinoma↗

PubMed2002

[Effect of cholesterol in bile on cholecystokinin receptor in the gallbladder].

OBJECTIVE: To assess the effect of cholesterol in bile on cholecystokinin receptor (CCK-R) in the gallbladder. METHODS: One hundred Guinea pigs were randomly divided into four groups, 25 animals for each. The control group was fed a standard diet, and the cholesterol group fed a diet containing 2% cholesterol. After taking the 2% cholesterol diet for two weeks, the natural group persisted on the standard diet, and the treated group was perfused by traditional Chinese medicine. Serum cholecystokinin (CCK) level in the portal vein and maximal binding capacity (B(max)) and Kd of CCK-R in the gallbladder were measured in the four groups by RIA and RBA, and the concentrations of cholesterol in bile were also observed. RESULTS: Compared with the control group, after high-cholesterol feeding for two weeks, the gallbladder emptying rate [(65.83 +/- 7.32)% approximately (47.22 +/- 5.24)%] and B(max) of CCK-R [(60 +/- 27) approximately (32 +/- 13) fmol/mg protein] and in decreased fasting gallbladder volume (FV) [(0.89 +/- 0.26) approximately (1.34 +/- 0.61) cm(3)] and concentration of cholesterol [(0.44 +/- 0.11) approximately (0.60 +/- 0.13) mmol/L] in bile increased, but no change was in the serum CCK level and Kd of CCK-R in the cholesterol group. Compared with the natural group, after two-week in take of herb decoction of qingre lidan and liqi huoxue, FV [(1.27 +/- 0.60) approximately (0.90 +/- 0.27) cm(3)], RV [(0.85 +/- 0.45) approximately (0.32 +/- 0.12) cm(3)], FB [(0.92 +/- 0.35) approximately (0.73 +/- 0.21) cm(3)], RB [(0.76 +/- 0.34) approximately (0.29 +/- 0.08) cm(3)] in the treated group decreased significantly; but gallbladder emptying rate [(43.06 +/- 4.27)% approximately (67.01 +/- 6.82)%] increased significantly. The concentration of cholesterol in bile was lower in the treated group than in the natural group [(0.59 +/- 0.14) approximately (0.43 +/- 0.10) mmol/L], but no change was found in the serum CCK level. Bmax of CCK-R in the treated group increased significantly [(39 +/- 19) approximately (59 +/- 11) fmol/mg protein], Kd of CCK-R showed no significant changes between the treated group and natural group. CONCLUSION: High cholesterol in gallbladder bile causes defective muscle contraction by down-regulating CCK-R in the gallbladder, so the reduction of cholesterol concentration of bile may contribute to gallbladder contraction.

Animals↗

PubMed2003

[Significance of expression of epidermal growth factor (EGF) and its receptor (EGFR) in chronic cholecystitis and gallbladder carcinoma].

BACKGROUND & OBJECTIVE: Epidermal growth factor(EGF) and its receptor(EGFR) play an important role in tumorigenesis. Cholelithiasis and cholecystitis were closely related to gallbladder carcinoma. This study was designed to investigate the relationship between the expression of EGF and EGFR in chronic cholecystitis and gallbladder carcinoma. METHOD: SABC immunohistochemistry was used to determine the expression of EGF, EGFR, and proliferating cell nuclear antigen (PCNA) in surgically resected specimens of 41 gallbladder carcinomas, 26 simple hyperplasia tissues, 14 dysplasia tissues,and 10 normal gallbladder tissues. RESULTS: The positive expression rates of EGF and EGFR were higher in gallbladder carcinomas(63.4%,70.7%) and dysplasia tissues (71.4%,85.7%) than in simple hyperplasia tissues (15.4%,27%) and normal gallbladder tissues (0%,0%)(P< 0.01); PCNA counting score tended to increase with the severity of mucosa change degree(P< 0.01), which were 1.0 in normal tissues, 1.0 in simple hyperplasia tissues, 1.9288+/-0.9972 in dysplasia tissues,and 3.0488+/-0.669 in gallbladder carcinomas. Significantly positive correlation were shown between EGF,EGFR, and PCNA(P< 0.05). There was no correlation between EGF, EFGR, and PCNA expression and tumor TNM stage(P>0.05). CONCLUSION: Expression of EGF and EGFR is involved in the gallbladder carcinogenesis, and is related to high activity of cell proliferation.

Adult↗

PubMed2004

Ultrasonographic evaluation of gallbladder volume in diabetics.

AIMS AND OBJECTIVE: Ultrasonographic determination of gallbladder volume in diabetics [both type I and type 2], it's comparison with a control group, and correlation of gallbladder volume in diabetics with parameters such as age, sex, body mass index, parity, hyperlipidaemia, and autonomic neuropathy. MATERIALS AND METHOD: Ninety one cases of diabetes mellitus and 40 healthy controls were recruited for the study. A detailed history and physical examination were recorded. Laboratory investigations done were--fasting and postprandial blood sugar, glycosylated haemoglobin, microalbuminuria, and serum lipid profile. Autonomic neuropathy was determined by using simple non-invasive bedside tests. Fasting gallbladder volume was measured by ultrasonography (calculated by ellipsoid formula). RESULTS: The mean fasting gallbladder volume was 18.20 +/- 2.54 ml in type I diabetics and 25.87 +/- 13.90 ml in type 2 diabetics, with a minimum value of 9.30 ml and maximum value of 88 ml. When type 2 diabetics were subgrouped according to the presence of autonomic neuropathy, higher gallbladder volumes were seen in patients with autonomic neuropathy. CONCLUSIONS: Cholecystomegaly, to a significant degree, was found in type 2 diabetics in the present study. It was significantly correlated with age, body mass index, and the severity of autonomic neuropathy. In male type 2 diabetics, gallbladder volume was significantly correlated with LDL cholesterol levels. In female type 2 diabetics, gallbladder volume was significantly correlated with waist-hip ratio. Gallbladder volume also had significant correlation with proliferative diabetic retinopathy, but not with glycaemic control, microalbuminuria, hypertension, or the duration of diabetes.

Adult↗

PubMed2006

Relationship between weight loss and gallbladder motility in obese women.

OBJECTIVE AND AIM: Most studies have detected impairment of gallbladder motility among obese compared with nonobese people. However, the relationship between gallbladder motility and weight loss is not well defined. The aim of this study was to evaluate the relationship between percent of weight loss and gallbladder motility during weight-reducing programs in obese women. PATIENTS AND METHODS: Thirty-four premenopausal obese women (body mass index >30 kg/m2) were included in the study. Following an overnight fast, fasting and postprandial 15-, 30-, 45-, 60-, 75-, 90-, 120- and 150th-minute gallbladder volumes and ejection fractions were evaluated with real-time ultrasonography as baseline and repeated after sixth months of weight-reducing programs. The lowest postprandial gallbladder volume was accepted as the residual volume. Gallstone formation was found in three (8.8%) patients during the study period, and these patients were dropped out. Thirty-one obese women were divided into three groups based on weight loss percent (group 1: 11 patients, weight loss <5%; group 2: 10 patients, weight loss 5-10%; group 3: 10 patients, weight loss >10%). RESULTS: Fasting gallbladder volume and all ejection fractions were not significantly different between baseline and after sixth months in all groups (p>0.05). Residual volume was decreased after sixth months in only group 3 (p=0.005). Difference of fasting and residual volumes, and ejection fractions at baseline and after sixth months was similar in all groups (p>0.05). There was a positive correlation between weight loss and the change of residual volume (r=0.395, p=0.028). CONCLUSION: Our findings suggest no relationship between degree of weight loss and ejection fraction. However, decreased residual volume and late-phase gallbladder volumes indicate gallbladder motility changing in patients who had >10% weight loss.

Adult↗

PubMed1991

[Gallbladder carcinoma as an incidental finding].

Between March 1982 and December 1990, 903 patients underwent elective cholecystectomy. In 40 patients cholecystectomy was performed for gallbladder carcinoma. 15 malignomas (1.7%) were found incidentally. Preoperatively no anamnestic or diagnostic tumor signs were found in this group of patients. An en-bloc-resection of the gallbladder with resection of the bordering liver segments was performed when gallbladder carcinoma was diagnosed intraoperatively. When the diagnosis was established by postoperative histology, a relaparotomy with liver resection and lymphnode-dissection was done, except in one case (T-1a stage). Histology showed adenocarcinoma in 11 out of 15 cases. No significant difference in the course of the disease was observed in patients with gallbladder carcinoma of different types. The hospital mortality rate was 0% after curative and palliative surgical treatment of gallbladder carcinoma. Patients with T-1 and T-2 stage have survived without tumor-recurrence up to now. The median survival time after surgery for gallbladder carcinoma in T-3 stage was 17 months, and 8 months in T-4 stage. The morbidity rate after elective cholecystectomy is low and hospital mortality is 0%. According to the short survival times in advanced stages of gallbladder carcinoma, a prompt cholecystectomy in symptomatic gallbladder lithiasis or chronic cholecystitis is advocated.

Adenocarcinoma↗

PubMed1990

Postprandial gallbladder emptying in patients after pancreatoduodenectomy. A preliminary report.

The study was undertaken to establish the pattern of gallbladder emptying in patients after pancreato-duodenectomy with the gallbladder preserved. 14 patients were examined. The preliminary examination revealed pathologic changes of the gallbladder in 5 patients, they were excluded from further investigations. The mean initial gallbladder volume, and the mean gallbladder maximum ejection fraction in patients after pancreatoduodenectomy were significantly lower as compared with controls. The pattern of gallbladder emptying was markedly flattened in the majority of patients, accompanied by alternate emptying and refilling of the gallbladder. On the basis of the above-mentioned observations we confirm the necessity to remove the gallbladder during pancreatoduodenectomy.

Adult↗

PubMed1988

Calcitonin gene-related peptide inhibits gallbladder contractility.

Calcitonin gene-related peptide (CGRP), a 37-amino acid peptide, is widely distributed in the gastrointestinal tract where it is colocalized with substance P. The effect of CGRP on gallbladder motility is unknown. The objective of this study was to examine the effect of CGRP on cholecystokinin-octapeptide (CCK-8) and substance P-stimulated gallbladder contraction in vivo and in vitro. In in vivo studies intragallbladder pressure was measured in response to bolus administration of CCK-8 (10(-15) to 10(-9) mol/kg) or substance P (10(-12) to 10(-7) mol/kg), either alone or with a continuous infusion of CGRP (10(-9) mol/kg/hr), in anesthetized guinea pigs. In in vitro studies the contractile force of guinea pig gallbladder muscle strips was examined in response to CCK-8 (10(-12) to 10(-7) mol/L) and substance P (10(-9) to 10(-6) mol/L), alone or with CGRP (10(-10) to 10(-6) mol/L). CGRP (10(-9) mol/kg/hr) inhibited in vivo gallbladder contraction that was stimulated by CCK-8, but not by substance P. CGRP alone produced a significant (p less than 0.05) dose-related decrease in the resting tension of gallbladder strips in vitro. CGRP (10(-6) mol/L) inhibited gallbladder muscle tension in vitro, stimulated by both CCK-8 and substance P. These studies show that CGRP can affect gallbladder motor activity by decreasing smooth muscle tone and that CGRP can antagonize the action of CCK and substance P. CGRP may be involved in the physiologic control of gallbladder emptying and refilling.

Animals↗

PubMed1989

Carcinoma of the gallbladder and extrahepatic bile duct in autopsy cases of the aged, with special reference to its relationship to gallstones.

To demonstrate correlation between occurrence of carcinoma and that of gallstone of the gallbladder and biliary tract, we reviewed the protocols of gallbladder and extrahepatic biliary duct carcinoma and cholelithiasis of 4,482 cases (male 2,237, female 2,245, mean age 77.7 yr) autopsied at the Department of Pathology, Tokyo Metropolitan Geriatric Hospital, during the 27 yr from 1960 to 1986. Gallbladder carcinoma was found in 94 cases, or 2.1%. The incidence was higher in the female than in the male (male 24, female 70, p less than 0.01). Gallstone of the gallbladder was found in 957 cases or 21.4%. In the male, incidences of gallbladder carcinoma and stone increased with age until the lower half of the ninety, whereas in the female, no such tendency was found after the sixties. Incidence of gallbladder carcinoma was significantly higher in the cases with cholecystolithiasis than in those without stone (p less than 0.01). Furthermore, the incidence of gallbladder stones in the cases with relatively early carcinoma was significantly higher than that of those without carcinoma (p less than 0.01). Cholesterol stones were more common than bilirubinate in the carcinoma patients. These results suggest the importance of cholecystolithiasis, especially that of the cholesterol stones, as a background factor of gallbladder carcinoma. Extrahepatic bile duct carcinomas were present in 33 cases or 0.7% (male 19, female 14, no sex preference). The incidence was significantly higher in the cases with stones than in those without stones of the extrahepatic bile ducts (p less than 0.01). However, the fact that small stones were found in the upstream portions of obstruction of biliary tracts and no stone was found at operations in the 11 operated cases suggested that stones may be secondary to the cancerous growth.

Adolescent↗

PubMedDate not supplied

[Scintigraphic study of gallbladder emptying in chronic Chagas' disease].

Previous studies on gallbladder motility in Chagas' disease, which is known to be associated with diffuse destruction of intramural neurons, have produced conflicting results. In the present study we reevaluated this question by submitting chronic chagasic patients (n = 18) and controls (n = 12) to a cholescintigraphic study of gallbladder emptying in response to a single intra-venous injection of 60 ng/kg cerulein 90 min after administration of 99mTC-HIDA. Five min. before and immediately before carulein injection, as well as every 5 min. up to 45 min. after the stimulus, images of the gallbladder were obtained with a gamma-camera coupled to a computer. The counts obtained for regions of interest corresponding to the gallbladder, permitted the calculation of the ejection fraction of the organ and the construction of individual gallbladder emptying curves. The ejection fractions values for the total sample of chagasic patients (median 67.8%; variation, 4.0 to 99.0%), although higher than those for the control group (median: 34.2% variation, 13.1 to 88.0%), were not statistically significant (p greater than 0.05). However, analysis of the individual curves for the chagasics permitted identifying 2 subgroups, one of which (n = 9) showed values very similar to those for the controls, whereas the other (n = 9) showed a very rapid and intense gallbladder emptying. It is concluded that impairment of the gallbladder innervation in Chagas' disease may lead to heterogeneous patterns of gallbladder emptying, with some patients being definitely hypersensitive to an exogenous cholecystokinetic agent.

Adult↗

PubMed1987

Gallbladder contraction in patients with irritable bowel syndrome.

Impaired gallbladder contraction has been previously shown in pregnant women, in people with diabetes, celiac disease, and cystic duct syndrome, and in postvagotomy patients. In this study gallbladder contraction was measured by real-time ultrasonography in 32 subjects: 8 healthy controls, 12 diabetics and 12 with the irritable bowel syndrome. Contraction was expressed by four parameters: fasting gallbladder volume, residual gallbladder volume after maximal contraction, maximum percent of gallbladder emptied, and time elapsed until maximal contraction occurred. The main difference between the control subjects and the groups with diabetes and irritable bowel syndrome was found in the fasting and residual gallbladder volumes. Fasting volumes were twice as large in the irritable bowel syndrome (30.37 +/- 3.0 ml) as in the control subjects (15.15 +/- 0.69 ml, P less than 0.001). Residual volumes were also twice as great in those with irritable bowel syndrome, compared with the control subjects (12.91 +/- 2.18 ml vs. 5.6 +/- 0.58 ml, P less than 0.01). Similar, but less pronounced differences were found when the diabetic and the control subjects were compared. Fasting volumes were 21.7 +/- 2.62 ml for diabetic individuals vs. 15.15 +/- 0.69 ml for control subjects (P less than 0.05) and residual volumes were 10.87 +/- 2.69 vs. 5.6 +/- 0.58 ml (P = 0.1), respectively. The maximum percent emptied and the time elapsed until maximum contraction occurred were not statistically different. Also, no statistical difference was found between the diabetic individuals and those with irritable bowel syndrome in any of the parameters studied. Increased fasting and residual gallbladder volumes in the irritable bowel syndrome are changes that may promote sequestration and precipitation of cholesterol or calcium salts in the gallbladder of patients with lithogenic bile, as seen in diabetic individuals.

Adolescent↗

PubMed1987

[Left-sided gallbladder: report of a case and study of 26 cases in Japan].

A case of left-sided gallbladder with an anomaly of the intrahepatic portal vein and cholesterol polyps of the gallbladder is presented. A 23-year-old man with sudden onset of epigastric pain, fever and abdominal irritation was admitted to our hospital and an emergency celiotomy was carried out. The gallbladder lay on the left side of the round ligament, that is, it was a left-sided gallbladder. Since operative findings such as cholecystitis, gastrointestinal perforation and pancreatitis were not observed, no more procedures were done. Postoperative ultrasonography showed some interesting findings as follows: multiple echogenic nonshadowing small polypoid lesions which did not change in size and shape during a 2.5 year interval were detected and were thought to be cholesterol polyps. The tail of the gallbladder was situated on the left side of the round ligament and the motion of the gallbladder as determined by postural exchange was not floating. These findings are compatible with a left-sided gallbladder. The left branch of the portal vein did not form an umbilical portion as is usually expected and the right branch formed a cystic structure similar to a normal umbilical portion with the anterior, posterior and medial branches ramified. The round ligament arose from the cul-de-sac of the umbilical portion. Twenty-six cases of left-sided gallbladder from the Japanese literature were reviewed and discussed.

Abnormalities, Multiple↗

PubMed1985

Gallstones and risk of gallbladder cancer.

The relationship between gallstones and gallbladder cancer was investigated in a case-control study in 131 subjects with gallbladder cancer and 2,399 subjects without gallbladder cancer. Included in the study were male and female subjects from 3 racial groups: white, black, and Southwestern American Indian. For the non-Indian group there was a significant relationship between gallstones and gallbladder cancer, with an overall estimated relative risk (RR) of 4.4 (95% confidence interval, 2.6-7.3). For the Indian population the overall estimated RR was much higher: RR = 20.9; 95% confidence interval = 8.1-54. By the combination of the RR, the prevalence of gallstones, and the overall incidence of gallbladder cancer, the risk of gallbladder cancer was calculated in each population for subjects with untreated gallstones. In older subjects with gallstones the estimated 20-year cumulative risk for gallbladder cancer ranged from 0.13% in black males to 1.5% in Indian females. It was concluded that the risk of gallbladder cancer in untreated subjects with gallstones is heterogeneous, depending on race and sex as well as the period of exposure to gallstones.

Aged↗

PubMed1983

[Effects of isometheptene on gallbladder contraction].

In order to verify the influence of the adrenergic system on the gallbladder contraction the Authors studied the effect of isometeptene, a sympathomimetic drug active on beta receptors, on gallbladder emptying. The gallbladder was studied on 6 subjects using a real-time (linear array) equipment with a 3,5 MHz transducer. In fasting subjects the gallbladder emptying was obtained by a fatty meal. In the next day the fatty meal stimulation was associated with the administration of isometeptene. The mean values +/- S.D. of the follow parameters were evaluated: -gallbladder basal volume -gallbladder residual volume both after fatty meal and after the association with isometeptene -gallbladder maximum emptying percentage in two experiences. The results show that the isometeptene doesn't inhibit significantly the gallbladder emptying induced by a fatty meal.

Adult↗

PubMed1978

Nocturnal gallbladder storage and emptying in gallstone patients and healthy subjects.

Nocturnal hepatic bile is supersaturated with cholesterol, and increased storage of this "lithogenic" bile in gallstone patients might explain why they more frequently have supersaturated fasting state gallbladder bile than patients without gallstone disease. To test this possibility, we measured the fraction of nocturnal hepatic bile stored in the gallbladder in 5 patients whose gallstones had been previously dissolved by chenodeoxycholic acid, in 5 control subjects without gallstone disease matched for age, sex, and weight, and in 5 young healthy males. We developed a new method based on the use of indocyanine green as a bile marker. The hourly rate of input into the duodenum of indocyanine green was measured during its constant, prolonged intravenous infusion. When gallbladder storage occurred, indocyanine green input was less than the infusion rate; when gallbladder emptying occurred, input exceeded the infusion rate. The method was validated by showing that duodenal output of indocyanine green was identical to intravenous input of indocyanine green in 2 cholecystectomized patients. When the method was applied, emptying of the gallbladder with meals was documented, and calculations showed that more than half of the bile secreted at night bypassed the gallbladder in both gallstone patients and control subjects. No difference in "cholecystodynamics" was observed between gallstone patients, matched control subjects, and young healthy men. Our results validate a method for quantitating gallbladder storage and emptying in men, but fail to support the speculation that an important pathogenetic step in gallstone formation is increased storage of supersaturated nocturnal bile in the gallbladder.

Adult↗