SEARCH · PubMed Health

Results for “Gallbladder”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources

PubMed2002

Functional analysis of gallbladder using three-dimensional ultrasound: preliminary results.

In evaluating gallbladder function, the clinical feasibility of three-dimensional (3-D) ultrasound (US) using volumetric acquisition was assessed in 30 patients: 18 patients with gallstones and 12 healthy volunteers. 3-D ultrasonography was performed in each patient before and after a fat-meal test. The ejection fraction of the gallbladder from two volumes measured by computer-aided analysis was calculated. There were significant differences in the gallbladder ejection fractions among the diseased and control groups (p < 0.0001). Compared with the results of oral cholecystograms, the ejection fraction of the gallbladder using 3-D volumetry and the grade of oral cholecystography showed good correlation in predicting the gallbladder dysfunction (gamma = 0.71, p = 0.002). Even in cases failing oral cholecystography, the gallbladder ejection fraction using 3-D US was calculated without any difficulty. Conclusively, volumetric acquisition of 3-D US enables us to evaluate gallbladder function and provides a reliable diagnostic yield superior to oral cholecystography.

Adult↗

PubMedDate not supplied

Evidence of impaired gallbladder function in patients with non-insulin-dependent diabetes mellitus by quantitative cholescintigraphy.

Non-insulin-dependent diabetes mellitus (NIDDM) is considered to predispose impaired gallbladder function and an increased prevalence of gallbladder disease. The aim of this study was to evaluate the gallbladder function of patients with NIDDM by quantitative technetium-99m-labeled imino-diacetic acid analogue (Tc-99m DISIDA) cholescintigraphy. One hundred and forty-five NIDDM patients (100 males, 45 females; age: 58.7+/-9.5 years) with the absence of autonomic or peripheral neuropathy and without gallbladder or liver disorders were enrolled in this study. The patients were categorized by blood sugar control (HbA(1c)> or =10% as a poor blood sugar control group and HbA(1c)<10% as a good blood sugar control group) and disease duration (diabetic duration > or =10 years as a longer-duration group and diabetic duration <10 years as a shorter-duration group). In addition, 60 normal controls (38 males, 22 females; age: 59.1+/-10.2 years) were also studied for comparison. All NIDDM patients and normal controls underwent Tc-99m DISIDA cholescintigraphy, and the filling fraction (FF) and ejection fraction (EF) of gallbladder were calculated. The results showed significant difference between (1) NIDDM patients versus normal controls in FF and EF, (2) poor versus good blood sugar control of NIDDM patients in FF and EF, and (3) longer versus shorter disease duration of NIDDM patients in FF and EF. Our study, including a large number of subjects, showed that gallbladder function of patients with NIDDM is more impaired than the normal controls; and impaired gallbladder function in NIDDM patients is related to disease duration and blood sugar control.

Blood Glucose↗

PubMed1998

Effect of oral cisapride on gallbladder emptying during fasting and postprandial states.

RATIONALE AND OBJECTIVES: The purpose of the study was to determine the effect of orally administered cisapride on gallbladder emptying in healthy subjects during fasting and postprandial states. MATERIALS AND METHODS: Gallbladder emptying was assessed by means of ultrasonography in 10 healthy male subjects (age range, 25-33 years; mean age, 28.6 years +/- 3.2 [standard deviation]) under four randomly applied conditions: (a) after oral intake of a placebo tablet, (b) after oral intake of 10 mg of cisapride during fasting, (c) after oral intake of a placebo tablet followed 30 minutes later by ingestion of 300 mL of fresh whole milk (postprandial emptying), and (d) after oral intake of 10 mg of cisapride followed 30 minutes later by ingestion of 300 mL of milk. RESULTS: Cisapride given during the fasting state induced gallbladder contraction by 44.1% +/- 12.6 (standard deviation) of its initial volume. Gallbladder emptying started after 19.4 minutes +/- 12.6 and reached its peak 51 minutes +/- 5.7 later. The ejection fraction after administration of only cisapride was significantly less than that after placebo and milk ingestion (44.1% +/- 12.6 vs 60.6% +/- 8.5, P < .0002). Oral administration of cisapride 30 minutes before milk consumption induced gallbladder emptying, which started approximately 10 minutes before milk ingestion. The ejection fraction after administration of cisapride with milk was significantly greater than that after consumption of placebo and milk (67.1% +/- 8.8 vs 60.6% +/- 8.5, P < .02). CONCLUSION: Oral cisapride induces contraction of the gallbladder during the fasting state and enhances postprandial gallbladder emptying.

Administration, Oral↗

PubMed1999

Effect of experimental acalculous cholecystitis on gallbladder smooth muscle contractility.

Gallbladder motility is impaired in chronic cholelithiasis but has not been studied in acute acalculous cholecystitis. The aim of this study was to determine the effects of acute acalculous inflammation on gallbladder contractility using the common bile duct ligation (CBDL) model in guinea pigs. Three groups of guinea pigs were studied: CBDL, normal, and sham surgical controls. Gallbladder dimensions were measured, and muscle strips were used for histology and in vitro contractility studies. CBDL resulted in progressive gallbladder distension, increased serum bilirubin, and gallbladder inflammation. There was a progressive decline in muscle contractility in the CBDL group as evidenced by a decrease in the contractile response to potassium and bethanechol with the duration of CBDL. In conclusion, CBDL in the guinea pig produces acute gallbladder inflammation and decreased gallbladder muscle contractility. Direct inhibition of muscle function is indicated by impaired contractile responses to potassium depolarization and bethanechol stimulation. Although the mechanism of the decrease in contractility with CBDL is unknown, we speculate that impaired muscle contractility is secondary to inflammation and may play a role in the clinicopathology of acute acalculous cholecystitis.

Animals↗

PubMed1999

Expression of MUC2, MUC5AC and MUC6 apomucins in carcinoma, dysplasia and non-dysplastic epithelia of the gallbladder.

To date, nine apomucins have been characterized and their expression in malignant and premalignant lesions is under evaluation. The purpose of this study was to characterize immunohistochemically the expression of MUC2 (colonic/ intestinal type), MUC5AC (gastric surface type), and MUC6 (pyloric gland type) apomucins in 55 patients with gallbladder carcinoma (10 with in situ carcinoma, 45 with invasive carcinoma), 20 patients with gallbladder dysplasia, and 15 patients with non-dysplastic gallbladder. MUC2 was expressed mainly in 'goblet type' cells. The frequency was increased in non-dysplastic gallbladder (47%), dysplasia (75%), and in situ carcinoma (100%), and decreased in invasive carcinoma (58%). Carcinoma cells expressing MUC2, which were usually distributed at superficial areas, and well-differentiated carcinoma expressed MUC2 more extensively than moderately and poorly differentiated ones. MUC5AC was frequently expressed in gallbladder irrespective of non-dysplastic epithelia, dysplasia and carcinoma. MUC5AC was expressed also in carcinoma cells at deeply invasive sites. MUC6 was expressed frequently in pseudopyloric gland metaplasia as well as dysplasia and carcinoma. In conclusion, non-dysplastic gallbladder has a similar phenotype to gastric pyloric mucosa. Gallbladder carcinoma exhibits both intestinal and gastric surface phenotypes in the early stage of carcinogenesis, with the gastric surface phenotype dominant in invasive carcinoma.

Adult↗

PubMed2003

Cyclooxygenase-2 expression in the gallbladder of patients with anomalous arrangement of the pancreaticobiliary duct.

BACKGROUND/PURPOSE: Anomalous arrangement of the pancreaticobiliary duct (AAPBD) is frequently associated with gallbladder carcinoma. Cyclooxygenase (COX) is a key enzyme in the synthesis of prostaglandins, and 2 isoforms have been identified: COX-1 and COX-2. Overexpressed in several precancerous lesions, the COX-2 isoform is thought to be involved in chronic inflammation and carcinogenesis. To determine whether COX expression correlates with biliary histology in patients with AAPBD, the authors investigated the expression of COX-1 and COX-2 in the gallbladder of patients with AAPBD. METHODS: Gallbladder specimens were obtained from 31 patients with AAPBD (mean age, 5.0 years), and from 7 patients with other hepatobiliary diseases as controls (mean age, 2.0 years). The authors quantified levels of COX-1 and COX-2 by the extent and intensity of staining after immunohistochemistry using anti-COX-1 and anti-COX-2 antibodies. RESULTS: Mucosal hyperplasia of the gallbladder was identified in 18 of 31 patients with AAPBD. The gallbladder epithelium of all specimens expressed COX-2. Marked expression of COX-2 was noted in specimens with mucosal hyperplasia, the mean immunoreactive score of which was significantly higher than that of specimens without mucosal hyperplasia (7.50 +/- 1.86 and 5.62 +/- 2.26, respectively; P =.021). In contrast, COX-1 expression was not detected in any specimen. CONCLUSIONS: Enhanced expression of COX-2 is related to mucosal hyperplasia of the gallbladder in patients with AAPBD. Thus, COX-2 may play a regulatory role in the proliferation of gallbladder epithelium, which may lead to carcinogenesis in patients with AAPBD.

Adolescent↗

PubMed1996

[Morphometric findings of the healthy pediatric gallbladder in ultrasound].

AIM: Ultrasonographic determination of gallbladder wall thickness, volume and excretion in children. METHOD: In 76 children (1-16 years) we determined the volume of the fasting and stimulated gallbladder by the ellipsoid formula (length X width X depth X 0.523). We also measured the gallbladder wall thickness. Stimulation was performed with a standardised breakfast. RESULTS: We always measured the gallbladder wall thickness 3 mm or less and did not find a difference between fasting and stimulation. There was no correlation between gallbladder wall thickness and status of contraction. The healthy gallbladder should excrete at least 25% of the fasting volume within 1 hour. CONCLUSION: Ultrasound is a suitable method to determine the excretion of the gallbladder. In children standardised meals can be used as stimulus instead of commercial stimulating meals.

Adolescent↗

PubMedDate not supplied

Rokitansky-Aschoff sinuses of the gallbladder are associated with black pigment gallstone formation: a scanning electron microscopy study.

Rokitansky-Aschoff sinuses are the result of hyperplasia and herniation of epithelial cells through the fibromuscular layer of the gallbladder wall and are usually referred to as adenomyomatosis. The role of this study is to demonstrate that Rokitansky-Aschoff sinuses of the gallbladder are a risk factor for the formation of black pigment gallstones. A total of 179 removed gallbladders, were hystologically examined. Sixty-four of the 179 consecutive cholecystomized patients had typical adenomyomatosis. Thirty-eight of the 64 patients with adenomyomatosis had black pigment gallstones, alone (n=22) or in association with single (n=12) or multiple (n=4) cholesterol gallstones in the same gallbladder. Twelve of these patients did not have the typical risk factors for black stones (hemolysis, cirrhoses, gastrectomy, etc). Gallstones were examined by infrared spectroscopy and X-ray diffractometry. In addition, in a subset of 14 patients, the gallstones and the gallbladder wall were examined by scanning electron microscopy. At least in the initial phases of formation, Rokitansky-Aschoff sinuses were found close to small intraparietal vessels and sometimes they contained black pigment microstones. After the fourth to fifth decades of life, black gallstones can be found in the Rokitansky-Aschoff sinuses and in the main gallbladder lumen. Black pigment gallstones can form in Rokitansky-Aschoff sinuses of the gallbladder in absence of the typical risk factors for bilirubin suprasaturation of bile.

Adenomyoma↗

PubMed2001

Infection after laparoscopic cholecystectomy: effect of infected bile and infected gallbladder wall.

OBJECTIVE: To assess the incidence of infected bile and gallbladder wall infection at the time of laparoscopic cholecystectomy, and find out if they influenced the rate of postoperative infective complications. DESIGN: Prospective study. SETTING: District hospital, Kuwait. SUBJECTS: All 279 patients who had their gallbladders removed laparoscopically for gallbladder disease between September 1995 and August 1998. INTERVENTIONS: Samples of bile and gallbladder wall were taken from all patients and cultured separately for aerobic and anaerobic bacteria. Patients with complicated gallbladder disease (n = 80) were given preoperative therapeutic antibiotics for five days (cephalosporin plus metronidazole), and other high-risk patients (n = 138) were given prophylactic ceftriaxone either 1 g x 3 starting at induction of anaesthesia (n = 42), or a single dose at induction (n = 96). MAIN OUTCOME MEASURES: Incidence of infected cultures, and infective morbidity. RESULTS: 26 specimens of bile (9%) and 56 specimens of gallbladder wall (20%) were infected. Two patients in whom neither specimen had shown any growth developed minor infections at the umbilical port. No patient in whom either specimen was infected developed an infective complication. CONCLUSIONS: The overall rate of infective complications was negligible, and did not correlate with the presence of bacteria in the bile or gallbladder wall. This is probably a reflection of our aggressive antibiotic regimen in the management of high-risk patients.

Adolescent↗

PubMed2005

Surgical significance of superficial cancer spread in early gallbladder cancer.

BACKGROUND: A considerable percentage of gallbladder cancers are accompanied by superficial cancer spread adjacent to the main tumor, therefore cholecystectomy for early gallbladder cancer must be performed carefully to avoid leaving cancer cells at the surgical margins. METHODS: Thirty-two patients with gallbladder cancer invading no more than perimuscular connective tissue underwent surgical resection at our medical center. After the operation, resected specimens were investigated macroscopically and microscopically to clarify the clinicopathological features and the risk factors of superficial cancer spread. RESULTS: Sixty-six percent of all cases (21 cases) had superficial cancer spread. Comparison between the cases having superficial cancer spread and the cases without it revealed that the macroscopic morphology of the primary tumor and the depth of cancer invasion in the gallbladder wall were significantly different between the two groups. Furthermore, multivariate analysis indicated that 'superficial raised type' in macroscopic morphology was an independent predictive factor for having superficial cancer spread. Superficial cancer spread from the main tumor located in the neck of the gallbladder grows predominantly in the direction of the fundus. More advanced gallbladder cases were accompanied by more extensive superficial spread. CONCLUSIONS: Superficial cancer spread is frequently observed adjacent to the gallbladder cancer, especially in the superficial raised type. A negative margin should be confirmed by intraoperative frozen section histology while performing cholecystectomy.

Adult↗

PubMed1997

Pravastatin has no effect on bile lipid composition, nucleation time, and gallbladder motility in persons with normal levels of cholesterol.

Pravastatin dissolves gallstones in patients with hypercholesterolemia by reducing the cholesterol saturation index (CSI) of bile. There are few reports on effect of pravastatin on bile lipids, CSI and nucleation time (NT) in patients with gallstones and normal plasma lipid levels, or on the effect of pravastatin on gallbladder motility. Therefore we studied the effect of pravastatin on bile lipids, CSI, NT, and gallbladder motility in persons with normal cholesterol levels. We included 10 patients (ages 32 +/- 8 years; 6 men) with symptomatic gallstones and normal plasma lipid profiles. Estimation of bile lipids, CSI, and NT in duodenal bile and gallbladder motility were done using standard methods. Subsequently each patient was given 40 mg pravastatin daily for 1 month. At completion of pravastatin therapy, bile lipids and gallbladder motility studies were repeated. After pravastatin therapy, we found no significant reduction in bile cholesterol (11.2 +/- 3.2 vs. 10.4 +/- 2.8 mmol/l), bile acids (114.6 +/- 7.4 vs. 133 +/- 16 mmol/l), phospholipids (23 +/- 3.5 vs. 24 +/- 6.2 mmol/l), CSI (1.28 +/- 0.4 vs. 1.22 +/- 0.3), and nucleation time (7 +/- 3 vs. 7 +/- 3 days). In addition, there was no significant change in gallbladder fasting volume (26 +/- 3 vs. 26.6 +/- 3 ml), residual volume (14.6 +/- 1.1 vs. 15.08 +/- 1.4 ml), ejection fraction (44% vs. 43%), and rate constant of gallbladder emptying (0.018/min vs. 0.022/min). One-month therapy with pravastatin does not alter bile lipids, CSI, NT, and gallbladder contractility in persons with normal levels of cholesterol.

Adult↗

PubMed2000

Effects of exercise training on gallbladder function in an obese female population.

PURPOSE: Aerobic exercise may influence gallstone disease pathogenesis through its effect on gallbladder motility. The purpose of this investigation was to examine the effects of exercise training on gallbladder emptying in obese women. METHODS: Twenty-seven obese subjects were randomized into one of two groups: exercise (E) (five 45-min brisk walking sessions per week at 75.2 +/- 0.5% of maximum heart rate) and controls (C). Gallbladder function via cholescintigraphy, cardiorespiratory fitness, and body composition were measured in all subjects before and after a 12-wk intervention period. In each cholescintigraphy trial subjects ingested an 8-oz liquid meal 45 min after injection of 99mTc disofenin to promote gallbladder emptying. Gallbladder areas were then scanned for 60 s and then every 5 min for 60 min. RESULTS: VO2max increased significantly by 9% for E when compared with that for C (P < 0.001). Within E postprandial gallbladder ejection fraction (EF) increased significantly after training (39.5 +/- 4.9% to 54.7 +/- 6.5%, P < 0.05); however, this 15.2% increase in EF was not significantly greater than the change reported in the controls. CONCLUSIONS: Results indicate that 12 wk of moderate exercise training does improve cardiorespiratory fitness but does not significantly effect gallbladder emptying in obese women.

Adult↗

PubMed2006

Ultrasonographic evaluation of gallbladder functions in patients with irritable bowel syndrome.

BACKGROUND: The aim of the present study was to evaluate gallbladder function in irritable bowel syndrome (IBS) patients. METHODS: The functions of gallbladder were investigated every 30 min for 4 h. In addition, ejection fraction of the gallbladder was calculated from the fasting and post-prandial volumes. RESULTS: In IBS patients and healthy controls, fasting gallbladder volumes were 19.64 +/- 3.09 mL and 20.04 +/- 1.82 mL, and residual volumes after 3 h were 3.36 +/- 6.82 mL and 9.74 +/- 1.50 mL. Except for the residual volume after 3 h, all these results were not statistically significant. Residual volume after 3 h was statistically significantly lower in the IBS patients than in the controls (P < 0.001). Ejection fraction of the gallbladder was significantly higher in the IBS patients than in the controls (84% vs 55%, P < 0.001). CONCLUSIONS: Gallbladder contraction in patients with IBS was not different from that of a control group at post-prandial second hour but was signigicantly more pronounced at the end of 3 h when compared with controls. Ejection fraction of the gallbladder was higher in IBS patients when compared with controls.

Adult↗

PubMed1999

Frequent expression of mucin core protein MUC1 in non-neoplastic gallbladder mucosa from patients with pancreaticobiliary maljunction.

BACKGROUND: Gallbladder carcinoma is known to develop frequently in patients with pancreaticobiliary maljunction, though the causal relationship remains speculative. METHODS: Histopathologic changes, expression of mucin core protein MUC1 and MUC2, and cell proliferative activities in the gallbladder mucosa from 27 patients with panceaticobiliary maljunction and 21 control gallbladders were examined. Three cases of pancreaticobiliary maljunction were associated with gallbladder carcinoma. RESULTS: The lining epithelia of the non-neoplastic gallbladder mucosa of pancreaticobiliary maljunction showed frequently papillary hyperplasia and higher proliferative activities, when compared to the control. In 3 cases with carcinoma, MUC1 was expressed on the luminal border and in the cytoplasm of carcinoma cells, particularly in de-differentiated and invasive areas. MUC1 was variably expressed on the luminal surface of the lining epithelia of non-neoplastic gallbladder mucosa in babies, children, youths and adults with pancreaticobiliary maljunction. However, such expression was focally seen in 2 of the 21 control cases (p<0.01). MUC2 was scattered in the hyperplastic and carcinomatous epithelial cells appearing as goblet cells in pancreaticobiliary maljunction and control groups. CONCLUSIONS: This study suggests that persistent MUC1 expression and increased cell proliferative activities of non-neoplastic gallbladder epithelium of the patients with pancreaticobiliary maljunction after birth reflect an altered phenotype of epithelial cells and these abnormalities may be related to carcinogenesis in such patients.

Adult↗

PubMedDate not supplied

Motility of the gastrointestinal tract and gallbladder during long-term total parenteral nutrition in dogs.

BACKGROUND: The motility of the gastrointestinal tract during total parenteral nutrition (TPN) remains poorly understood. The objective of this study was to determine the motility pattern not only in the gastrointestinal tract but also in the gallbladders of dogs maintained by TPN. METHODS: Central venous catheters were inserted through the external jugular vein of 5 dogs and 6 strain gauge force transducers were sewn to the stomach, small intestine, and gallbladder. Two weeks later, oral food was discontinued and motility was recorded for 24 hours after the first migrating motor complex (MMC) was confirmed in the stomach as pre-TPN. TPN was started and continued for 4 weeks, and patterns of motor activity during TPN were recorded for 24 hours at the end of each week. RESULTS: The durations of MMC in the stomach, duodenum, and gallbladder in pre-TPN were 118 +/- 3 minutes, 118 +/- 2 minutes, and 118 +/- 2 minutes, respectively, but in the first week of TPN they were 432 +/- 56 minutes, 431 +/- 56 minutes, and 386 +/- 29 minutes, respectively. TPN times were significantly longer than those of pre-TPN (corrected p < .005). The durations of MMC in jejunoileum did not alter between pre-TPN and TPN. The occurrences of phase III in the stomach, duodenum, and gallbladder in pre-TPN were 12/d, but during TPN they were reduced significantly (corrected p < .005). CONCLUSIONS: TPN did not affect the motility of the jejunoileum but did inhibit the motor activities of the stomach, duodenum, and gallbladder. The inhibition of gallbladder contraction observed during TPN may be one of the factors inducing gallbladder disease.

Animals↗

PubMed1982

Naturally occurring polypoid hyperplasia and papilloma in gallbladders of the fat sand rat (Psammomys obesus terraesanctae Thomas).

The gallbladders of 256 fat sand rats (131 males and 125 females) seven to 41 months old were studied histologically. None of the sand rats had been used in experimental procedures prior to death. Diffuse polypoid hyperplasia or papilloma of the gallbladder mucosa was found in 49 sand rats. Of these lesions, 45 were present in 126 sand rats in the second half of their lifespan. Neither concretions nor signs of chronic inflammation were seen. Signs of focal epithelial growth activity were seen in either form of lesion. Epithelial hyperplasia was excessive in two gallbladders, and one was diagnosed as carcinoma-in-situ. The papilloma in one sand rat revealed transition to adenocarcinoma, with penetration into the deep layers of the gallbladder. Preneoplastic nodules were found in the liver as frequently as reported previously, but they were unrelated to gallbladder lesions. The unusual high incidence of spontaneous epithelial proliferation in the gallbladder mucosa in sand rats of both sexes through several generations suggests this strain as a model in the experimental study of tumorigenesis in the gallbladder.

Animals↗

PubMed2005

Gallbladder histopathology during murine gallstone formation: relation to motility and concentrating function.

C57L mice are susceptible and AKR mice are resistant to gallstone formation. We studied in male mice of both strains gallbladder histopathology, cholecystokinin-induced emptying, and concentrating function at 0, 14, 28, and 56 days on a lithogenic diet. Gallbladder wall thickness increased on the diet, with stromal granulocyte infiltration, progressive fibrosis, edema, and epithelial cell indentation, particularly in C57L. Strong basal cholecystokinin octapeptide-induced gallbladder emptying (70% of fasting volumes) occurred in both strains, but fasting gallbladder volumes were significantly larger in C57L (14.8 +/- 2.2 microl vs. 8.8 +/- 1.0 microl). On the diet, fasting volumes increased exclusively in C57L (28.6 +/- 2.9 microl on day 56), with progressively decreased emptying (27% of fasting volumes on day 56). Gallbladder emptying remained normal in AKR. Gallbladder concentrating function decreased on the lithogenic diet (especially in C57L), coinciding with decreased aquaporin-1 (AQP1) and AQP8 expression at the mRNA and protein levels. In additional experiments, similar downregulation of AQP1 and AQP8 mRNA expression occurred in farnesoid X receptor (FXR)-deficient mice after 1 week on the lithogenic diet, without any difference from corresponding wild-type mice. In conclusion, during murine lithogenesis, altered gallbladder histology is associated with impaired motility, reduced concentrating function, and decreased AQP1 and AQP8 expression, the latter without the involvement of the FXR.

Animals↗

PubMed1993

Prospective study of the long-term effects of somatostatin analog (octreotide) on gallbladder function and gallstone formation in Chinese acromegalic patients.

This article reports the changes in gallbladder function examined by ultrasonography in 20 Chinese patients with active acromegaly treated with sc injection of the somatostatin analog octreotide in dosages of 300-1500 micrograms/day for a mean of 24.2 +/- 13.9 months. During treatment with octreotide, 17 patients developed sludge, 10 had gallstones, and 1 developed acute cholecystitis requiring surgery. In all of 7 patients examined acutely, gallbladder contractility was inhibited after a single 100-micrograms injection. In 8 patients followed for 24 weeks, gallbladder contractility remained depressed throughout therapy. After withdrawal of octreotide in 10 patients without gallstones, 8 patients assessed had return of normal gallbladder contractility within 1 month. In 8 of the remaining 10 patients who developed gallstones during treatment, gallbladder contractility normalized in 5 patients (3 of whom has disappearance of their stones within 3 weeks), and remained depressed in 3 (2 of whom had stones present at 6 months). Our results suggest that the suppression of gallbladder contractility is the cause of the successive formation of bile sludge, gallstones, and cholecystitis during octreotide therapy in Chinese acromegalic patients. It is therefore very important to follow the changes of gallbladder function during long-term octreotide therapy of acromegalic patients.

Acromegaly↗