GALLBLADDER EMPTYING TO ENDOGENOUS AND EXOGENOUS STIMULATION IN CHRONIC-PANCREATITIS PATIENTS

Objectives: The present study was designed to analyze the underlying m echanism of gallbladder motor disturbance in chronic pancreatitis pati ents. Methods: Gallbladder emptying to endogenous (oral test meal, Dai yan 13 g) and exogenous stimulation (iv cerulein, 30 ng/kg for 5 min) was examined by real-time ultrasonography in 12 patients with chronic pancreatitis and 10 normal subjects (controls). Plasma cholecystokinin levels during the endogenous stimulation were measured by bioassay. R esults: In chronic pancreatitis patients compared with controls, the f asting gallbladder volume was significantly increased (29.5 +/- 2.2 vs . 21.5 +/- 2.8 ml), whereas the gallbladder emptying (percent change o f the basal volume) to oral test meal was significantly decreased. Nei ther cholecystokinin secretion induced by the test meal, nor the gallb ladder emptying response to intravenous cerulein, differed significant ly between the two groups. However, when chronic pancreatitis patients were divided according to pathogenesis, it became clear that gallblad der emptying to intravenous cerulein was significantly greater in pati ents with alcoholic chronic pancreatitis than in patients with idiopat hic pancreatitis. Conclusions: Gallbladder emptying during the intesti nal phase is generally reduced in patients with chronic pancreatitis, but gallbladder responsiveness to exogenous stimulation might be heter ogeneous according to the pathogenesis.