Motor activity of the gallbladder in systemic sclerosis

OBJECTIVE: We sought to measure gallbladder emptying in scleroderma patient s, when stimulated by exogenous cholecystokinin. METHODS: Twenty-eight consecutive scleroderma patients were evaluated. Ten were excluded for the presence of gallstones. Gallbladder motor function wa s studied in 18 patients and 18 controls, using specific parameters for the quantification of gallbladder emptying dynamics. Resting gallbladder volum es were compared using the Dodds method with real-time ultrasound. Cholecys tokinin (CCK)-stimulated gallbladder function (0.02 mu g/kg CCK intravenous infusion/30 min) was assessed by a scintigraphic technique using Tc-99m-DI SIDA. Five patients presented with CREST syndrome, 13 with the diffuse form of scleroderma. Four were men, 14 women (average age = 46.6 +/- 15.4 yr). Patients and controls were paired by gender, age, and weight. RESULTS: Resting gallbladder volumes were larger in the four men with scler oderma than in the women with this disease (p < 0.03, Mann-Whitney). The me an gallbladder resting volume in scleroderma patients was not different fro m the mean volume detected among controls (p = 0.25), even when controlling for gender (p = 0.78 for women, p = 0.08 for men), scleroderma disease sub type (p = 0.50), or disease duration (p = 0.48). Latency period, ejection p eriod, ejection rate, or ejection fraction as measured during cholecystokin in-stimulated scintigraphic studies were not significantly different betwee n patients and controls. A trend was detected for reduction of the ejection period in scleroderma women (p = 0.70) when compared with scleroderma men. More than 35% of the scleroderma patients presented biliary lithiasis. CONCLUSIONS: There was no significant difference in gall-bladder dynamics m easured by a scintigraphic technique in scleroderma patients, compared with controls, when gall-bladder motor function was evaluated by intravenous CC K. (Am J Gastroenterol 1999;94:3487-3491. (C) 1999 by Am. Coll. of Gastroen terology).