Normal fasting volume and postprandial emptying of the denervated donor gallbladder in liver transplant recipients.
OBJECTIVE
Truncal vagotomy causes gallbladder dilatation and possibly cholelithiasis. During liver transplantation, when the gallbladder is transplanted with the donor liver, the gallbladder and liver are extrinsically denervated. The aim of this study was to determine whether extrinsic denervation affects gallbladder volume and postprandial emptying.


METHODS
To evaluate fasting gallbladder volume, 26 transplant recipients underwent ultrasonography. Twenty-eight normal volunteers were controls. To evaluate postprandial contractility, seven transplant recipients underwent radionuclide gallbladder-emptying studies. Gastric emptying and cholecystokinin release were simultaneously determined after a fatty meal to exclude a difference in gallbladder stimulus. Sixteen normal volunteers were controls.


RESULTS
There were no differences in fasting gallbladder volume or postprandial contractility, gastric emptying, and cholecystokinin release between transplant patients and controls. Median fasting and postprandial gallbladder volumes for the transplant recipients (95% confidence) were 16 mL (12-34 mL) and 3 mL (0-8 mL), respectively, and for controls were 18 mL (13-21 mL; P = 0.73) and 3 mL (1-6 mL; P = 0.97), respectively.


CONCLUSIONS
These data do not show gallbladder dilatation or impaired postprandial gallbladder contraction in the extrinsically denervated gallbladder. This finding suggests that gallbladder dilatation may be caused by the unopposed activity of the sympathetic system after truncal vagotomy.
Vezina
W C
WC
Department of Nuclear Medicine, University Hospital, London, Ontario, Canada.
McAlister
V C
VC
Wall
W J
WJ
Engel
C J
CJ
Grant
D R
DR
Ghent
C N
CN
Hutton
L C
LC
King
M E
ME
Chey
W Y
WY
D000328:Adult; D002766:Cholecystokinin / Q000097:blood; D003714:Denervation; D004435:Eating; D005215:Fasting; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000294:innervation* / Q000502:physiology*; D005746:Gastric Emptying; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012016:Reference Values; D013270:Stomach / Q000000981:diagnostic imaging; D014019:Tissue Donors
D002766:Cholecystokinin