CORRELATION BETWEEN GALL-BLADDER FASTING VOLUME AND POSTPRANDIAL EMPTYING IN PATIENTS WITH GALL-STONES AND HEALTHY CONTROLS

To evaluate whether the extent of postprandial gall bladder emptying i s correlated with gall bladder fasting volume, gall bladder motility w as studied in 56 patients with cholesterol gall stone and 19 control p atients. Gall bladder volumes were determined sonographically, while c holecystokinin plasma values were measured radioimmunologically. Twent y three per cent of gall stone patients were classified as pathologica l contractors (residual fraction >mean +2SD of controls) and 77% as no rmal contractors. Normal but not pathological contractor patients exhi bited larger gall bladder fasting volumes (mean (SEM)) (24.7 (1.7) ml) than controls (15.3 (1.2) ml, p<0.001). In normal contractor patients and controls fasting volume was closely related with ejection volume (r=0.97, p<0.001) and residual volume (r=0.80, p<0.001). Although ejec tion volume was enlarged in normal contractor patients it did not comp ensate the increase in fasting volume. Thus, residual volumes were con siderably increased not only in pathological contractors (12.7 (2.5) m l, p<0.001) but also in normal contractor patients (7.0 (0.5) v 4.6 (0 .6) ml, p<0.001). Postprandial cholecystokinin secretion did not diffe r between patients and controls. It is concluded, that in normal contr actor patients gall bladder fasting volume is closely correlated with ejection and residual volume. Thus, fasting volume may be an essential factor affecting postprandial gall bladder emptying. Large fasting vo lumes in cholesterol gall stone disease could thereby contribute to bi le retention, which facilitates gall stone growth.