The relationship between in vivo emptying of the gallbladder, biliary pain, and in vitro contractility of the gallbladder in patients with gallstones: Is biliary colic muscular in origin?

Background: This study sought to determine whether there is a positive corr elation between gallbladder emptying, biliary pain, and in vitro contractil ity. Methods: Ultrasound measurements were carried out on 25 gallstone pati ents. The response of gallbladder strips to 1.75*10(-11) to 5.25*10(-7) M c holecystokinin-8 was recorded. In a second study 23 patients filled in pain questionnaires, and in vitro studies were again carried out. Results: Of f ive patients with no gallbladder emptying, four had in vitro contraction. O verall, a significant, positive linear correlation was found (P < 0.0001). In the second study in vitro contractility showed a positive linear correla tion with pain. Conclusion: Gallbladder emptying correlates with contractil ity. However, since most 'non-contractors' can contract, we suggest the ter m 'non-emptying' or 'emptying' to describe gallbladder dynamics. The positi ve correlation between pain and contractility suggests that biliary pain ha s a muscular component.