GALLBLADDER MOTILITY IN LAPAROSCOPIC CHOLECYSTECTOMY SPECIMENS

In vitro contractility of human and sheep gallbladders to cholinergic stimulation with carbachol and the effects of indomethacin on abnormal rhythmic activity were studied, Once hundred and thirdy-two gallbladd ers were obtained at laparoscopic cholecystectomy, 38 from patients wi th acute and 94 with chronic cholecystitis. In addition, 27 specimens of sheep gallbladders served as controls, Fundal preparations from pat ients with cholecystitis exhibit hypocontractility: no response in 72% or in the remainder a significantly reduced maximal contraction to ca rbachol. Regionally graded motor responses favoring propulsion of bile were abnormal in 44% of the gallbladders studied with more forceful c ontractions of the duct compared to the fundus, Abnormal early rhythmi c activity (ERA) of fundal preparations was only detected in gallbladd ers of patients (in 33%) but never in controls. In 80% of these, ERA w as blocked or reduced by indomethacin which can be interpreted as evid ence for a prostaglandin-mediated inflammatory response, We conclude t hat gallbladder motility in cholelithiasis secondary to muscarinic sti mulation is reduced and regionally graded motor responses favoring bil e expulsion are impaired. ERA can be blocked by indomethacin.