Evaluation of gallbladder motility in patients with liver cirrhosis - Relationship to gallstone formation

To investigate the postprandial gallbladder motility, including emptying an d refilling, in cirrhotic patients and to evaluate the relationship to the presence of gallstones and various humoral mediators, 82 patients with live r cirrhosis and 40 age- and sex-matched healthy subjects were enrolled into this study. Postprandial gallbladder volumes were measured with ultrasonog raphy every 15 min for 2 hr. Plasma levels of estradiol, testosterone, subs tance P, and nitrate/nitrite were also measured. Cirrhotic patients showed a higher prevalence of gallstones than healthy subjects (41% vs 15%, P = 0. 003), and the prevalence increased with the progression of liver cirrhosis (Child-Pugh class A: 26%, 8: 44%, and C: 65%, P = 0.02). Plasma levels of e stradiol, testosterone, and substance P, and nitrate/nitrite and estradiol/ testosterone ratios were not different between cirrhotic patients with and without gallstones. However, postprandial refilling of the gallbladders was significantly impaired in patients with cirrhosis, especially in those com bined with gallstones. There was no significant difference in the postprand ial gallbladder motility between cirrhotic patients with and without elevat ed plasma levels of estradiol, testosterone, and substance P and nitrate/ni trite, and estradiol/testosterone ratios. Gallstones were common in patient s with liver cirrhosis and the prevalence increased with the progression of liver diseases. Sex hormones, substance P, and nitrate/nitrite did not pla y major roles in the formation of gallstones in cirrhotic patients. Refilli ng of the gallbladder was significantly impaired in patients with liver cir rhosis, especially in those with gallstones, and may play an important role in the pathogenesis of gallstones.