Gallbladder emptying during high-dose cholecystokinin infusions. Effect in patients with gallstone disease and healthy controls.
BACKGROUND
Impaired gallbladder emptying is a pathogenetic factor in gallstone formation. To test whether gallbladder motility can be improved by high-dose cholecystokinin (CCK), gallbladder emptying was measured sonographically in 21 patients with cholesterol gallstone disease and 6 healthy controls.


METHODS
The effects of CCK infusions of 0.06 IDU/kg.min (group A, n = 11) and 0.12 IDU/kg.min (group B, n = 10) were compared with the response to a standard CCK infusion (0.02 IDU/kg.min). Controls received CCK at all infusion rates.


RESULTS
The ejection fraction was smaller after CCK infusion of 0.06 IDU/kg.min than after the standard stimulus (group A, 52 +/- 10 versus 64 +/- 10%, p < 0.05; controls, 66 +/- 10 versus 91 +/- 3%, p < 0.05). After infusion of 0.12 IDU/kg.min CCK ejection fractions decreased even more (group B, 44 +/- 16 versus 65 +/- 12%, p < 0.05; controls, 54 +/- 12 versus 91 +/- 3%, p < 0.05). High-dose CCK infusions shortened the ejection period markedly, whereas the ejection rate remained unaltered.


CONCLUSIONS
High-dose CCK does not improve gallbladder motility but blocks the ejection process early, leading to reduced gallbladder emptying in gallstone patients and healthy subjects.
Pauletzki
J
J
Dept. of Medicine II, University of Munich, Germany.
Cicala
M
M
Spengler
U
U
Sauerbruch
T
T
Paumgartner
G
G
D016022:Case-Control Studies; D002766:Cholecystokinin / Q000008:administration & dosage / Q000494:pharmacology*; D002769:Cholelithiasis / Q000737:chemistry / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002784:Cholesterol / Q000032:analysis; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D016473:Gallbladder Emptying / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography
D002766:Cholecystokinin; D002784:Cholesterol