RESTORATION OF GALLBLADDER CONTRACTILITY AFTER WITHDRAWAL OF LONG-TERM OCTEROTIDE THERAPY IN ACROMEGALIC PATIENTS

We sought to examine how the discontinuation of octreotide in long-ter m octreotide-treated acromegalic patients affects the well-documented side-effect of cholelithiasis. In 14 acromegalic patients, serum growt h hormone levels. insulin-like growth factor I levels and percentage o f relative gallbladder contractility were measured prior to and after the discontinuation of octreotide. Compared to pretreatment values. th e basal growth hormone and 5-h growth hormone profiles were 36% and 24 %, and 60% and 56% at the end of 1 and 2 weeks, respectively. Octreoti de was found to be eliminated completely from the serum within 3 days after its withdrawal. In all of six patients who did not develop galls tones, the percentage relative gallbladder contractility normalized wi thin 1 week. In eight patients who developed gallstones, four of them had restoration of normal contractility within 2 weeks. Our results sh ow that upon withdrawal of octreotide, gallbladder contractility retur ns to normal while growth hormone suppression persists for a longer pe riod of time. Therefore, discontinuation of octreotide therapy may all ow for the clearance of stagnated bile and hence decrease the incidenc e of cholelithiasis in acromegalic patients receiving long-term therap y.