GASTRIC-EMPTYING IN PATIENTS WITH GALLSTONE DISEASE WITH OR WITHOUT DYSPEPSIA - EFFECT OF CHOLECYSTECTOMY

Dyspepsia is a common complaint in patients presenting with gallstone disease. Since the stomach appears to be its site of origin, die prese nt study was undertaken to assess gastric emptying in patients with ga llstone disease and to find out its correlation with dyspeptic symptom s before and after cholecystectomy. Gastric emptying (t1/2) was prospe ctively assessed in 43 patients with symptomatic gallstones (29 with a nd 14 without dyspepsia). These data were compared with that of 20 hea lthy volunteers (control group). Delayed gastric emptying (> 112 min: mean + 2 s.d. of the control group) was observed in 18 patients (42%; P < 0.002), 10 of whom presented with dyspepsia and eight without (NS) . Re-evaluation in 18 of the 29 patients with dyspepsia, 3 months afte r cholecystectomy, revealed complete disappearance of symptoms in thre e, improvement in 11 and no change in four patients. After 6 months, t wo patients had reverted back to their pre-operative dyspeptic status; resulting in three patients completely cured, nine partially cured an d six without any change in their dyspeptic status at this time. Gastr ic emptying was delayed in nine of the 18 patients before cholecystect omy. After cholecystectomy, normal emptying was observed in all but on e patient (P < 0.005). Dyspeptic symptoms, however, completely disappe ared in one patient, improved in five and remained unchanged in three. In the remaining nine patients, gastric emptying was normal both befo re and after cholecystectomy. Gallstone disease is associated with del ayed gastric emptying but this delay was not the cause of dyspepsia in these patients. Cholecystectomy normalizes gastric emptying, a findin g that has not been reported previously. However, on the basis of gast ric emptying alone, it is not possible to predict the outcome of chole cystectomy.