GALLBLADDER EMPTYING, PLASMA-LEVELS OF ESTRADIOL AND PROGESTERONE, AND CHOLECYSTOKININ SECRETION IN LIVER-CIRRHOSIS

Defective gallbladder emptying has been proposed as a possible accesso ry pathogenetic factor to explain the increased prevalence of gallston es in liver cirrhosis. In this study we have evaluated the fasting vol ume and the meal-stimulated emptying of the gallbladder, the plasma le vels of estradiol and progesterone, and the basal and postprandial sec retion of cholecystokinin in Child A cirrhotic patients compared to no rmal subjects. Basal (42.2 +/- 27 vs 22.8 +/- 8.4 ml) (P < 0.002) and residual (8.4 +/- 8.7 vs 4.6 +/- 3.8 ml) (P < 0.05) gallbladder volume s were higher in cirrhotics but neither the integrated gallbladder res ponse to meal nor the maximal percentage of emptying was significantly different. Circulating estradiol and progesterone was slightly increa sed in only 1/13 and 5/13 cirrhotics, respectively. In eight cirrhotic s and seven normals taken from the overall populations, the secretion of cholecystokinin was also measured. The fasting plasma level of chol ecystokinin was higher in the cirrhotics (6.71 +/- 5.08 vs 2.02 +/- 0. 46 pmol/liter) (P < 0.01). The meal-stimulated integrated plasma chole cystokinin response also was greater in cirrhotics (438.5 +/- 615 pmol /liter/270 min) than in normals (153 +/- 170.4 pmol/liter/270 min), bu t this difference was not significant because of the small study popul ation. In spite of a normal kinetics of postprandial emptying, cirrhot ic patients show increased fasting gallbladder volume and increased pl asma levels of basal and postprandial cholecystokinin. Circulating est radiol and progesterone do not seem to be responsible for the large ga llbladder volume found in liver cirrhosis.