EFFECT OF ENDOSCOPIC SPHINCTEROTOMY ON GALLBLADDER MOTILITY

In experimental animals, sphincterotomy facilitates passage of solids from the gallbladder and inhibits gallstone formation apparently by im provement in gallbladder emptying. In humans, however, gallbladder emp tying has not been studied following endoscopic sphincterotomy (ES) in patients with gallstones. We therefore prospectively studied resting and cerulin-stimulated gallbladder volumes by real time ultrasonograph y in 15 patients of choledocholithiasis with gallbladder in situ (eigh t with and seven without gallbladder calculi) before and after (after bile duct clearance) ES. ES significantly lowered resting gallbladder volume (21.2 +/- 10.6 vs 11.1 +/- 5.0; P < 0.0001) and cerulin-stimula ted residual gallbladder volume (10.8 +/- 5.6 vs 4.4 +/- 2.1; P < 0.00 01). ES also significantly increased the gallbladder ejection fraction (47.3 +/- 12.1% vs 58.8 +/- 11.1%; P < 0.0001). The rate constant for gallbladder emptying after cerulin infusion also increased significan tly after ES (-0.022/min vs -0.031/ min; P < 0.0001). Significant impr ovement in gallbladder motility was observed in both groups of patient s with and without gallbladder calculi. ES significantly improves gall bladder motility in humans.