EFFECT OF CISAPRIDE ON GALLBLADDER EMPTYING AND PLASMA CCK IN NORMAL AND VAGOTOMIZED WOMAN SUBJECTS

Previous studies have provided conflicting results on the effects of c isapride on gallbladder emptying in response to a meal. We studied six volunteers and six patients after a truncal vagotomy in a double-blin d, placebo-controlled, prospectively randomized study using 10 mg cisa pride four times a day for three days. Gallbladder volume was quantita ted using ultrasonography, and plasma CCK levels were measured with a sensitive and specific radioimmunoassay using the DINO antibody before and for 90 min after a fatty, mixed meal. Plasma CCK levels were unch anged after treatment with cisapride in both groups. No prokinetic eff ect was observed on the gallbladder either in normal subjects or vagot omized patients. Paradoxically, residual volume (RV) was increased in the vagotomized patients after treatment with cisapride: RV cisapride 7.1 (4.1-15.9) mi, RV placebo 5.1 (3.8-14) mi, P < 0.05. Further work is required to clarify the mechanisms of action of cisapride on the ga llbladder and the sphincter of Oddi. The use of cisapride during litho lytic therapy may impair gallbladder emptying and delay stone clearanc e.