T. Meguro et al., GALLBLADDER EMPTYING TO ENDOGENOUS AND EXOGENOUS STIMULATION IN CHRONIC-PANCREATITIS PATIENTS, The American journal of gastroenterology, 89(2), 1994, pp. 225-231
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.