Gallbladder motility and cholecystokinin secretion in chronic pancreatitis: relationship with exocrine pancreatic function.
OBJECTIVE
Postprandial gallbladder motility is regulated mainly by the hormone cholecystokinin (CCK). Since CCK secretion may be reduced in patients with pancreatic insufficiency (PI), we studied postprandial gallbladder motility in these patients.


METHODS
Fifteen patients with PI due to chronic pancreatitis and 17 healthy control subjects were studied. Gallbladder volumes (ultrasonography) and plasma CCK concentrations (RIA) were determined at regular intervals for 120 min after meal ingestion. Urinary PABA and faecal fat excretion were measured to determine pancreatic exocrine function.


RESULTS
Patients with PI had larger fasting gallbladder volumes than controls (48 +/- 6 cm3 versus 29 +/- 2 cm3; p < 0.01). Gallbladder ejection volume at time 120 min was not significantly different between patients with PI (14 +/- 4 cm3) and controls (20 +/- 2 cm3). However, the percentage postprandial gallbladder emptying in patients with PI was significantly reduced compared to controls (at 120 min: 29 +/- 8% versus 68 +/- 3%; p < 0.001). Residual postprandial gallbladder volume was increased in patients with PI compared to controls (at 120 min: 34 +/- 4 cm3 versus 9 +/- 1 cm3; p < 0.001). Postprandial endogenous CCK secretion was significantly reduced in patients with PI compared to controls (78 +/- 13 pM.120 min versus 155 +/- 14 pM.120 min; p < 0.001). Postprandial gallbladder emptying (%) was related to the degree of exocrine pancreatic insufficiency (r = 0.81; p < 0.001).


CONCLUSIONS
In patients with pancreatic insufficiency due to chronic pancreatitis: 1) fasting and residual postprandial gallbladder volumes are significantly increased; 2) postprandial CCK secretion and percentage gallbladder contraction are significantly reduced; 3) percentage postprandial gallbladder emptying is related to the degree of pancreatic exocrine insufficiency.
Gielkens
H A
HA
Department of Gastroenterology-Hepatology, University Hospital Leiden, The Netherlands.
Eddes
E H
EH
Vecht
J
J
van Oostayen
J A
JA
Lamers
C B
CB
Masclee
A A
AA
D000328:Adult; D000368:Aged; D002766:Cholecystokinin / Q000097:blood / Q000378:metabolism*; D002908:Chronic Disease; D005260:Female; D005704:Gallbladder / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000503:physiopathology*; D010191:Pancreatic Polypeptide / Q000097:blood; D010195:Pancreatitis / Q000378:metabolism* / Q000503:physiopathology*
D010191:Pancreatic Polypeptide; D002766:Cholecystokinin