Interdigestive gallbladder emptying, antroduodenal motility, and motilin release patterns are altered in cholesterol gallstone patients

The role of interdigestive gallbladder emptying in gallstone formation is u nknown. In fasting healthy subjects, gallbladder emptying is associated wit h antral phase III of the migrating motor complex (MMC) and high plasma mot ilin. Therefore, gallbladder volumes and motilin levels were measured durin g 13 MMC cycles in 10 cholesterol gallstone patients and compared with 20 M MC cycles in 10 healthy subjects. MMC cycle length was longer in gallstone patients than in healthy subjects (158.2 +/- 17.0 vs 105.5 +/- 10.4 min, re spectively; P < 0.05), due to longer phase I (39.8 +/- 5.7 vs 17.2 +/- 3.7 min, respectively; P < 0.05). In contrast to healthy subjects, gallstone pa tients had no significant fluctuations of gallbladder volume during the MMC cycle, and motilin concentrations were not different in MMC cycles with ph ase III originating in antrum or duodenum. During MMC cycles with phase III originating in the duodenum, motilin levels were twice as high in gallston e patients as in healthy subjects (P < 0.002). In conclusion, cholesterol g allstone patients have an abnormal MMC and motilin release pattern. Their i nterdigestive gallbladder emptying is reduced and dissociated from the MMC. These disturbances may contribute to gallstone formation.