Postprandial gallbladder motility during long term treatment with the long-acting somatostatin analog SMS 201-995 in acromegaly.
The effects on gallbladder motility of long term treatment with the somatostatin analog SMS 201-995 (SMS) were studied in five patients with acromegaly treated for 6-32 months with 200-300 micrograms SMS daily. SMS (100 micrograms) or placebo was injected sc 45 min before a standard breakfast. Gallbladder volume (ultrasonography), plasma cholecystokinin (CCK), and pancreatic polypeptide (PP) were measured until 120 min after the meal. SMS completely suppressed the postprandial gallbladder contraction, despite a blunted, though still statistically significant, increase in plasma CCK from 1.6 +/- 0.2 pmol/L to an average of 3.7 +/- 1.7 pmol/L (P less than 0.01). The postprandial plasma PP peak after placebo was replaced by a slight but statistically significant decrease after SMS (P less than 0.05). A statistically significant correlation between the plasma CCK values and corresponding gallbladder volumes was seen only after placebo injection, not in the SMS study. We conclude that during long term treatment of acromegalics with SMS, an injection of 100 micrograms, sc, completely abolishes gallbladder contraction for at least 2 h after a standard breakfast, despite blunted, but still significant, CCK release. The data suggest a decreased sensitivity of the gallbladder to endogenous CCK during long term treatment with SMS. Careful control of patients with respect to the formation of gallstones is recommended.
Department of Internal Medicine, University Hospital Nijmegen, The Netherlands.
P A
PA
van Liessum
W P
WP
Hopman
G F
GF
Pieters
J B
JB
Jansen
A G
AG
Smals
G
G
Rosenbusch
P W
PW
Kloppenborg
C B
CB
Lamers
D000172:Acromegaly / Q000188:drug therapy* / Q000503:physiopathology; D000328:Adult; D002766:Cholecystokinin / Q000097:blood; D004435:Eating; D005260:Female; D005704:Gallbladder / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015282:Octreotide / Q000627:therapeutic use*; D010191:Pancreatic Polypeptide / Q000097:blood
D010191:Pancreatic Polypeptide; D002766:Cholecystokinin; D015282:Octreotide