Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Gallbladder Emptying”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed1998

Bile lithogenicity and gallbladder emptying in patients with microlithiasis: effect of bile acid therapy.

BACKGROUND & AIMS: Biliary cholesterol supersaturation, rapid nucleation of cholesterol, and altered gallbladder motility are prerequisite for gallstone formation. However, the pathogenesis of microlithiasis is not clear. The aim of this study was to determine the abnormalities of gallbladder emptying and bile composition in patients with microlithiasis. METHODS: Nucleation time, cholesterol saturation index (CSI), and gallbladder emptying were studied in patients with microlithiasis (n = 10), patients with gallstones (n = 10), and healthy volunteers (n = 10). Bile analysis was repeated in 6 patients with microlithiasis treated with ursodeoxycholic acid (UDCA) for 8 weeks. RESULTS: Nucleation time was shorter in patients with microlithiasis and those with gallstones than in healthy volunteers (P < 0.0001). Patients with microlithiasis had longer nucleation time than those with gallstones (P < 0.001). There was no difference in cholesterol levels and CSI in gallstone and microlithiasis patients. However, healthy volunteers had lower cholesterol levels (P < 0.01) and CSI (P < 0.01). Patients with microlithiasis had prolongation of nucleation time (P < 0.001) and lowering of CSI (P < 0.001) after UDCA therapy. Gallbladder ejection fraction was higher in microlithiasis patients than in gallstone patients (P < 0.01) but lower than in healthy volunteers (P < 0.01). CONCLUSIONS: Patients with microlithiasis have longer nucleation time and better gallbladder emptying than patients with gallstones. Bile abnormalities can be successfully corrected with UDCA therapy in patients with microlithiasis.

Adult↗
PubMed1992

Gallbladder emptying stimuli in obese and normal-weight subjects.

Gallbladder stasis may be an important factor in the pathogenesis of cholesterol-gallstone formation in some individuals. We investigated gallbladder function in a group of nondieting, gallstone-free, healthy subjects with normal (22 +/- 1 kg/m2) and high (36 +/- 1 kg/m2) body mass indexes. Fasting gallbladder volume (28.2 +/- 4.4 ml) and residual volume after maximal emptying (8.4 +/- 2.3 ml) in high-body-mass index subjects were not significantly different from those of normal-body-mass index subjects (20.5 +/- 2.5 ml and 4.2 +/- 1.3 ml, respectively). The percentage of gallbladder emptying (71% +/- 5%) and the rate of gallbladder emptying (-1.9 +/- 0.3 x 10(-2) min-1) in high-body-mass index subjects in response to a maximal emptying stimulus was similar to the percentage of emptying (78% +/- 6%) and rate of emptying (-2.3 +/- 0.6 x 10(-2) min-1) in normal-body-mass index subjects. A liquid meal containing less than 1 gm fat, 14 gm protein and 6 gm carbohydrate resulted in both a decreased rate of gallbladder emptying and an increased residual gallbladder emptying and an increased residual gallbladder volume in both groups. The addition of 10 or 20 gm (but not 4 gm) of fat to the liquid meal restored gallbladder emptying to the maximal-stimulus level. These results demonstrate that gallbladder emptying in response to a single liquid meal stimulus is not altered in obesity and that dose-response relationships to fat are similar in obese and normal-weight individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Hyperglycemia reduces gallbladder emptying and plasma hormone secretion to modified sham feeding and regular feeding.

The purpose of this study was to investigate the effect of acute stable hyperglycemia on gallbladder motility, plasma cholecystokinin level and pancreatic polypeptide secretion. Gallbladder emptying in response to modified sham feeding and regular feeding was determined in six healthy subjects on two separate occasions during normoglycemia (serum glucose = 5 mmol/L) and during hyperglycemia (serum glucose = 15 mmol/L). Pancreatic polypeptide secretion was determined as an indirect measure of cholinergic tone. Gallbladder contraction in response to sham feeding during hyperglycemia (9% +/- 2%) was significantly (p < 0.05) reduced compared with that in normoglycemia (22% +/- 1%). During hyperglycemia, gallbladder emptying after meal ingestion (29% +/- 9%) was significantly (p < 0.05) less than that in normoglycemia (60% +/- 10%). Sham feeding did not affect plasma cholecystokinin levels. Regular feeding induced significant (p < 0.05) increases in plasma cholecystokinin levels in both experiments. However, integrated postprandial plasma cholecystokinin secretion was significantly (p < 0.05) reduced during hyperglycemia compared with that in normoglycemia (29 +/- 5 pmol.60 min vs. 58 +/- 10 pmol.60 min). Modified sham feeding-and feeding-stimulated pancreatic polypeptide secretion during hyperglycemia (235 +/- 95 pmol.90 min and 1,035 +/- 267 pmol.60 min, respectively) were significantly (p < 0.05) less than levels seen in normoglycemia (434 +/- 71 pmol.90 min and 1,961 +/- 219 pmol.60 min, respectively). This study indicates that gallbladder emptying and plasma hormone secretion in response to sham feeding and regular feeding are affected by blood glucose levels.

Adult↗
PubMed1982

Measurement of gallbladder emptying sequentially using a single dose of 99mTc-labeled hepatobiliary agent.

The gallbladder emptying response to a single large (20 ng/kg) and four equally divided sequential small (5 ng/kg each) doses of octapeptide of cholecystokinin at 20-min intervals was measured in a paired study in six normal subjects noninvasively and quantitatively by a nongeometric method using a gamma camera, computer, and 99mTc-labeled hepatobiliary agent. The gallbladder mean (+/- SD) ejection fraction after a single large dose (20 ng/kg) of octapeptide of cholecystokinin was 34 +/- 24% and after four sequential small (5 ng/kg each) doses was 42 +/- 14%, 45 +/- 28%, 37 +/- 22%, and 32 +/- 27%, respectively (p greater than 0.05). The results of this study indicate that the first part of the 5 ng/kg sequential octapeptide of cholecystokinin dose is as effective as the single 20-ng/kg dose. The gallbladder emptying requires continued presence of high levels of octapeptide of cholecystokinin in the serum closer to levels that initiate contraction and in the absence of which the gallbladder ceases to empty further despite the fact it has inherent capacity to do so. Each of four equal octapeptide of cholecystokinin doses given sequentially elicits, on the average, an equal degree of emptying response. The method has potential for application in the study of the pharmacological effects of drugs on the biliary dynamics using a single dose of 99mTc-labeled hepatobiliary radiopharmaceutical.

Adult↗
PubMed1995

Gallbladder emptying, plasma levels of estradiol and progesterone, and cholecystokinin secretion in liver cirrhosis.

Defective gallbladder emptying has been proposed as a possible accessory pathogenetic factor to explain the increased prevalence of gallstones in liver cirrhosis. In this study we have evaluated the fasting volume and the meal-stimulated emptying of the gallbladder, the plasma levels of estradiol and progesterone, and the basal and postprandial secretion of cholecystokinin in Child A cirrhotic patients compared to normal subjects. Basal (42.2 +/- 27 vs 22.8 +/- 8.4 ml) (P < 0.002) and residual (8.4 +/- 8.7 vs 4.6 +/- 3.8 ml) (P < 0.05) gallbladder volumes were higher in cirrhotics but neither the integrated gallbladder response to meal nor the maximal percentage of emptying was significantly different. Circulating estradiol and progesterone was slightly increased in only 1/13 and 5/13 cirrhotics, respectively. In eight cirrhotics and seven normals taken from the overall populations, the secretion of cholecystokinin was also measured. The fasting plasma level of cholecystokinin was higher in the cirrhotics (6.71 +/- 5.08 vs 2.02 +/- 0.46 pmol/liter) (P < 0.01). The meal-stimulated integrated plasma cholecystokinin response also was greater in cirrhotics (438.5 +/- 615 pmol/liter/270 min) than in normals (153 +/- 170.4 pmol/liter/270 min), but this difference was not significant because of the small study population. In spite of a normal kinetics of postprandial emptying, cirrhotic patients show increased fasting gallbladder volume and increased plasma levels of basal and postprandial cholecystokinin. Circulating estradiol and progesterone do not seem to be responsible for the large gallbladder volume found in liver cirrhosis.

Adult↗
PubMed1985

Defective gallbladder emptying and cholecystokinin release in celiac disease. Reversal by gluten-free diet.

Normal volunteers (n = 6), patients with untreated celiac disease and subtotal villous atrophy (n = 6), patients with nonresponsive celiac disease (n = 2), and patients with celiac disease on a gluten-free diet with a virtually normal biopsy specimen (n = 6) drank a liquid fat meal after an overnight fast. Gallbladder emptying was monitored by using 99mTc-eHIDA, and blood samples were taken for cholecystokinin estimation by radioimmunoassay after high-performance liquid chromatography. The half-times of gallbladder emptying were 20.4 +/- 2.9 min (mean +/- SEM) for normals and 22.1 +/- 2.8 min in treated patients with celiac disease (NS). In patients with untreated celiac disease half-times were 154.3 +/- 10.3 min (p less than 0.02 vs. normals and treated patients with celiac disease), and in 2 nonresponsive patients, half-times were 40.7 and 37.3 min. Integrated plasma cholecystokinin responses were 473 +/- 87 and 436 +/- 137 pmol X L-1 X 30 min-1 in normals and treated patients with celiac disease (NS). In untreated patients with celiac disease values were 16 +/- 9 pmol X L-1 X 30 min-1 (p less than 0.001 vs. normals and treated patients with celiac disease), and in nonresponsive patients values were 442 and 322 pmol X L-1 X 30 min-1. In 2 patients studied before and during gluten-free diet half-times for gallbladder emptying changed from 168.9 and 302.4 min to 20.1 and 23.4 min, and cholecystokinin responses changed from 0 and 45 to 623 and 298 pmol X L-1 X 30 min-1. Cholecystokinin immunoreactivity cochromatographing with cholecystokinin-octapeptide was responsible for 50%-60% of circulating cholecystokinin in normals and in treated patients but the small amount of cholecystokinin that was released in untreated patients with celiac disease cochromatographed with cholecystokinin-33/39. We conclude that there is a reversible defect of gallbladder emptying and cholecystokinin release in celiac disease.

Adult↗
PubMed1990

Gallbladder emptying following cholecystokinin and fatty meal in normal subjects.

A quantitative study of gallbladder emptying using 99mTc-HIDA as a bile tracer was performed with either CCK or a fatty meal as gallbladder stimulant. Its aims were to establish; (1) the reproducibility of CCK- and fatty-meal-induced gallbladder contraction, and (2) temporal patterns of gallbladder emptying following a physiological meal. Nineteen healthy, fasted volunteers were selected for 3-minute CCK administration (IV Boots Pancreozymin 2CHR units/kg) or a 40 g fatty meal. Each underwent repeat scans not less than 14 days after the first. Quantitative activity/time curves were drawn with computer analysis establishing gallbladder ejection fractions (GBEF) for each stimulus. Our results demonstrated: (1) poor reproducibility of CCK-induced gallbladder contraction precluding its diagnostic use, (2) improved but still variable meal-induced gallbladder contraction, and (3) evidence for a neurocephalic emptying response with a fatty meal stimulus.

Adult↗
PubMed1990

Postprandial gallbladder emptying in patients after pancreatoduodenectomy. A preliminary report.

The study was undertaken to establish the pattern of gallbladder emptying in patients after pancreato-duodenectomy with the gallbladder preserved. 14 patients were examined. The preliminary examination revealed pathologic changes of the gallbladder in 5 patients, they were excluded from further investigations. The mean initial gallbladder volume, and the mean gallbladder maximum ejection fraction in patients after pancreatoduodenectomy were significantly lower as compared with controls. The pattern of gallbladder emptying was markedly flattened in the majority of patients, accompanied by alternate emptying and refilling of the gallbladder. On the basis of the above-mentioned observations we confirm the necessity to remove the gallbladder during pancreatoduodenectomy.

Adult↗
PubMed1995

Effects of cisapride on gallbladder emptying and pancreatic polypeptide and cholecystokinin release in humans.

We investigated the effects of cisapride on gallbladder motility and on the release of pancreatic polypeptide and cholecystokinin in the fasting and postprandial states. Cisapride (7.5 mg) and/or a test meal was administered intraduodenally to seven healthy volunteers with or without atropine pretreatment (0.5 mg, i.m.). In the fasting state, cisapride increased gallbladder volume to 154% of the basal level, and significantly elevated plasma pancreatic polypeptide levels. The effects of cisapride were inhibited by atropine. In the postprandial state, integrated pancreatic polypeptide and cholecystokinin responses were increased by cisapride to 180% and 192%, respectively, of control values. Atropine inhibited the integrated gallbladder and pancreatic polypeptide response to about 60% of the control value, but did not affect the cholecystokinin response. These observations suggest that: (1) fasting gallbladder tone is influenced by cholinergic inhibitory mechanisms, (2) acetylcholine (ACh) is the final mediator for about 40% of the postprandial gallbladder emptying and pancreatic polypeptide response, and (3) coordination between the ACh-independent cholecystokinin response and ACh-dependent pancreatic polypeptide response may be important in the regulation of postprandial gallbladder emptying.

Adult↗
PubMed1979

Gallbladder emptying in response to cholecystokinin. A cholescintigraphic study.

The threshold and dynamics of gallbladder emptying in human subjects in response to cholecystokinin (Pancreozymin, Boots Co. Ltd) were defined by radionuclide imaging with a gamma camera. The radiopharmaceutical employed, 99mTc-HIDA, was taken up rapidly by the liver and efficiently excreted into the biliary system so that gallbladder filling was easily distinguishable from negligible background activity. Counts were recorded continuously on magnetic tape during i.v. infusion of sequentially increasing doses of cholecystokinin: Each dose level was maintained for 15 min. At later playback, the area of interest was adjusted to include only the gallbladder and to exclude radioactivity present in the gut during gallbladder emptying. In 19 normal subjects (10 male and 9 female), a threshold dose of cholecystokin was identified for gallbladder contraction: 0.010 Crick-Harper-Raper units/kg-min in 16 subjects, and 0.020 Crick-Harper-Raper units/kg-min in the remaining 3. The rate of emptying appeared smooth and linear at each dose level: Doubling the dose of cholecystokinin in every case significantly increased the emptying rate. There appeared to be no effect of increasing age on emptying more rapidly than females, but the difference was not significant. This cholescintigraphic technique would appear to offer a simple, accurate, yet noninvasive method for continuously monitoring the events during gallbladder contraction in humans.

Adult↗
PubMed1989

Effects of loxiglumide on gallbladder emptying in healthy volunteers.

This study evaluates the effects of the specific cholecystokinin receptor antagonist loxiglumide on gall-bladder emptying after a meal or after intravenous infusion of caerulein in humans. Ten healthy male volunteers were studied five times on separate days. The following five studies were performed in randomized order: (a) caerulein was intravenously infused at doses increasing from 7.5 to 120 ng/kg.h without the antagonist; (b) in addition to increasing doses of caerulein, loxiglumide was given intravenously at doses of 0.2, 1.0, or 5.0 mg/kg.h; (c) a solid-liquid 800-kcal meal was given without loxiglumide; (d) the 800-kcal meal was given with simultaneous infusion of 1 or 5 mg/kg.h loxiglumide; and (e) loxiglumide (5 mg/kg.h) was given. without caerulein or the test meal. Gallbladder volume was measured by ultrasound. Loxiglumide dose-dependently inhibited gallbladder emptying induced by caerulein or the meal. High doses of the antagonist did not only abolish meal-induced gallbladder emptying but increased gallbladder volume after administration of caerulein or the meal when compared with prior fasting values. The antagonist given alone markedly increased gallbladder volumes compared with prior fasting values. In conclusion, given alone markedly increased gallbladder volumes compared with prior fasting values. In conclusion, cholecystokinin is the hormone primarily and mainly responsible for mediation of gallbladder emptying after a regular meal. Cholecystokinin might also play a physiologic role in the regulation of the fasting tone of the gallbladder.

Adult↗
PubMed1999

[Correlation between gene expression of CCK-A receptor and gallbladder emptying in gallstone patients].

OBJECTIVE: To investigate the expression of CCK-A receptor and its relation with gallbladder hypomotility in patients with gallstone. METHODS: 20 patients with gallstone and 10 normal subjects were studied and gallbladder emptying function was measured by B ultrasonography. The other 8 patients without gallstone who died of accident were selected as controls for measuring mRNA expression of CCK-A receptor of gallbladder; RT-PCR was used to explore gene expression of CCK-A receptor of gallbladder. RESULTS: The gallbladder motility was significantly impaired in gallstone patients. The patients had lower mRNA expression of CCK-A receptor than control subjects (0.633 +/- 0.167 vs. 0.944 +/- 0.230, P < 0.01), and so did patients with impaired gallbladder motility then those with normal motility (0.544 +/- 0.124 vs. 0.768 +/- 0.131, P < 0.05). Furthermore, the change of expression of CCK-A receptors was markedly correlated with gallbladder emptying (r = 0.925, P < 0.01). CONCLUSIONS: mRNA expression of CCK-A receptor in gallstone patients decreases, which was related to gallbladder hypomotility. The down-regulation of gene expression of CCK-A receptor plays an important role in gallbladder hypomotility in patients with gallstone.

Cholecystolithiasis↗
PubMedDate not supplied

Stimulation of gallbladder emptying by intravenous lipids.

BACKGROUND: Few studies have dealt with the effect of i.v. administration of lipids on gallbladder emptying, and the results have been conflicting. METHODS: Five healthy volunteers, three women and two men, aged 26 to 54 years, (mean, 29 years) were studied. Gallbladder emptying was assessed by means of real-time ultrasonography. RESULTS: In all subjects, the infusion of a 10% fat emulsion (Intralipid; Kabivitrum, Stockholm) over 3 hours caused a reduction in gallbladder volume. This effect was statistically significant at about 80 minutes of lipid infusion and became progressively more marked as the infusion progressed, reaching a reduction of approximately 30% during the third hour of infusion. A significant relationship (p < .001) was found between the concentration of serum triglycerides and the degree of gallbladder volume decrease. In control studies, infusion of physiologic saline containing glycerol, the excipient of intralipid, caused no significant changes in gallbladder volume. CONCLUSIONS: The results indicate that i.v. infusion of lipids is able to stimulate significantly contraction of human gallbladder.

Adult↗
PubMed1996

Relationship between gastric and gallbladder emptying and refilling in normal subjects and patients with H. pylori-positive and -negative idiopathic dyspepsia and correlation with symptoms.

Gastric and gallbladder emptying and refilling was studied in 10 normal subjects and in 38 dyspeptic patients. H. pylori was determined in each dyspeptic on mucosal antral biopsy performed during endoscopy. Gastric and gallbladder emptying was evaluated by real-time ultrasonography. Normal subjects were evaluated after two solid-liquid meals of 340 kcal and 680 kcal. Dyspeptics were studied after the 340-kcal meal only. For each subject and patient, minimum gallbladder volume and percentage of gastric emptying at this point was determined. Gastric and gallbladder slope was also drawn, and the crossing point between the two slopes identified. In normal subjects with the 340-kcal and 680-kcal meal, minimum gallbladder volume occurred for a similar percentage of gastric emptying. The crossing point between the two slopes was computed at the same percentage of gastric and gallbladder refilling with both meals. With the 680-kcal meal, however, peak gallbladder contraction and the crossing point between the two slopes occurred significantly later than with the 340-kcal meal (P < 0.05). In dyspeptics with the 340-kcal meal, the parameters evaluated were similar to the ones computed in controls after the meal of 680-kcal, suggesting delayed gastric emptying and gallbladder refilling. The presence or absence of H. pylori and symptom score were not correlated with any of the parameters studied.

Adult↗
PubMed1995

Effect of extracorporeal shock-wave lithotripsy on gallbladder emptying in patients with solitary and multiple gallbladder stones.

In a prospective study, we investigated the effect of extracorporeal shock-wave lithotripsy (ESWL) on gallbladder contractility and on fasting and residual gallbladder volume in patients with solitary and multiple gallbladder stones with stone densities < 100 Hounsfield units (HU) and adequate gallbladder function. Twenty-five patients (seven males and 18 females, mean age 48.5 +/- 11.7 years) treated with ESWL were assigned to either group I, consisting of 13 patients with solitary stones < 20 mm diameter, or group II, including patients with two to three stones and maximum stone diameter of 30 mm. ESWL was performed with the MPL 9000 lithotripter. Gallbladder ejection fraction was determined using the method of Dodds after a 12-hr fast and following application of a standard stimulative meal. Gallbladder volume was measured by ultrasound over 90 min at 10-min intervals before ESWL, then at 1, 30, 120, and 210 days after ESWL. At 24 hr after ESWL, residual gallbladder volume increased in group I from 7.4 ml to 13.9 ml (P = 0.0567) and in group II from 6.5 ml to 20.2 ml (P = 0.0076). Thereafter, residual volumes returned to pre-ESWL levels. In group II, post-ESWL fasting volumes were significantly increased over initial values at all time intervals. Correspondingly, only at 24 hr after ESWL, ejection fractions decreased from 73.1% to 64.9% in group I and from 76.5% to 62.7% in group II. No statistically significant differences in gallbladder contractility between the two groups were observed at any point of the follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Evaluation of gallbladder emptying in patients with chronic liver disease by 99mTc-EHIDA hepatobiliary scintigraphy].

Gallbladder emptying after intramuscular injection of cerulein was investigated by 99mTc-EHIDA hepatobiliary scintigraphy in 23 patients with biliary disease, 55 patients with chronic liver disease, and 21 normal controls. The mean gallbladder ejection fraction in patients with gallstones and liver cirrhosis was significantly reduced compared with normal controls. (gallstones: 56.3 +/- 21.3%, LC with gallstones: 50.8 +/- 29.6%, LC without gallstones: 55.9 +/- 26.7%, vs. normal controls: 74.4 +/- 12.9%, p less than 0.01). The mechanism for sluggish gallbladder emptying in liver cirrhosis is unknown, however impaired emptying with bile stasis provides a potential pathophysiologic basis for the high frequency of pigment stones.

Adult↗
PubMed1994

[A preliminary study of gallbladder emptying in non-ulcer dyspepsia].

UNLABELLED: The relationship between non-ulcer dyspepsia (NUD) and gastric emptying was described in detail in our previous paper "study of gastric emptying and non-ulcer dyspepsia". The present study was designed to evaluate whether patients with non-ulcer dyspepsia present any alteration of gallbladder motility in response to a meal, and whether the altered gallbladder emptying coordinates with gastric emptying and is related with gastrointestinal symptoms. RESULTS: (1) There was no statistical difference of fasting gallbladder volume and GBEFmax between 38 NUD patients and 30 symptom-free controls. The gallbladder emptying rate in NUD patients however was either slower or faster than that of controls, it was associated with the dyspepsia symptoms of NUD patients. (2) Delayed gastric emptying did not affect gallbladder contraction.

Adult↗
PubMed1996

Effect of cisapride on gallbladder emptying and plasma CCK in normal and vagotomized human subjects.

Previous studies have provided conflicting results of cisapride on gallbladder emptying in response to a meal. We studied six volunteers and six patients after a truncal vagotomy in a double-blind, placebo-controlled, prospectively randomized study using 10 mg cisapride four times a day for three days. Gallbladder volume was quantitated using ultrasonography, and plasma CCK levels were measured with a sensitive and specific radioimmunoassay using the DINO antibody before and for 90 min after a fatty, mixed meal. Plasma effect was observed on the gallbladder either in normal subjects or vagotomized patients. Paradoxically, residual volume (RV) was increased in the vagotomized patients after treatment with cisapride: RV cisapride 7.1 (4.1-15.9) ml, RV placebo 5.1 (3.8-14) ml, P < 0.05. Further work is required to clarify the mechanisms of action of cisapride on the gallbladder and the sphincter of Oddi. The use of cisapride during litholytic therapy may impair gallbladder emptying and delay stone clearance.

Adult↗