title: Ultrasonographic assessment of gallbladder bile exchanges in healthy subjects and in gallstone patients.
abstract: Impaired gallbladder motility may contribute to gallstone pathogenesis by providing time for nucleation and aggregation of cholesterol crystals. Simultaneous scintigraphic-ultrasonographic techniques have been proposed to assess alternating phases of gallbladder emptying and filling. To evaluate patterns of gallbladder motility and of postprandial bile flow by means of a single ultrasonographic technique, 12 healthy volunteers and 20 gallstone patients underwent minute-by-minute gallbladder ultrasonography for 3 h postprandially. Mathematical analysis of volume measurements was used to estimate hepatic and cholecystic bile flux through the gallbladder. Compared to controls, gallstone patients showed greater amounts of unexchanged cholecystic-to-hepatic bile (11% vs. 1%, p <.001) and most of them showed impaired gallbladder washout efficacy. Utrasonographic values of bile exchanges were similar to those derived from scintigraphic-sonographic studies in comparable groups of subjects. This study provides new ultrasonographic variables, which better express gallbladder bile retention in gallstone patients and strongly discriminate gallstone patients from controls.
authors.affiliation: Dipartimento di Malattie dell'Apparato Digerente, Università Campus Bio Medico, Via Longoni 83, 00155 Rome, Italy. m.cicala@unicampus.it
authors.forename: M
authors.initials: M
authors.lastname: Cicala
authors.forename: M P
authors.initials: MP
authors.lastname: Guarino
authors.forename: P
authors.initials: P
authors.lastname: Vavassori
authors.forename: R
authors.initials: R
authors.lastname: Alloni
authors.forename: S
authors.initials: S
authors.lastname: Emerenziani
authors.forename: A
authors.initials: A
authors.lastname: Arullani
authors.forename: F
authors.initials: F
authors.lastname: Pallone
mesh_terms: D000328:Adult; D000368:Aged; D001646:Bile / Q000378:metabolism; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002779:Cholestasis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000502:physiology / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period / Q000502:physiology*; D012016:Reference Values; D013997:Time Factors; D014463:Ultrasonography