Gallbladder contractility and volume characteristics in gallstone dyspepsia.
OBJECTIVE
It is difficult to differentiate gallstone dyspepsia and functional dyspepsia by clinical symptoms and signs. We hypothesized that gallstone dyspepsia was related to abnormal gallbladder motility. We aimed to differentiate gallstone dyspepsia from functional dyspepsia by measuring gallbladder motility.


METHODS
We measured gallbladder volume changes in response to gastric distension (saline 500 mL) and fatty meal in 10 normal volunteers (controls) and 62 patients with gallstones and dyspepsia before cholecystectomy. Forty cholecystectomized patients were symptom free or had improvement (group I), while the remaining 22 patients had persistent dyspepsia (group II). Gallbladder volume change and ejection fraction were analyzed and compared among the three groups.


RESULTS
In group I, there were significant decreases in gallbladder volumes 5-25 min after gastric distension, compared to fasting volumes. Compared to normal volunteers and group II, group I had significantly decreased gallbladder volumes 10-20 min after drinking 500 mL of normal saline and 10 to 50 min after eating fatty meal.


CONCLUSIONS
Our results support the hypothesis that increased gallbladder contraction after gastric distension or fatty meal may be related to dyspeptic symptoms in uncomplicated gallstone disease. These findings may be useful in differentiating functional dyspepsia from gallstone dyspepsia, patients with the latter disease may benefit from laparoscopic cholecystectomy.
Division of General Surgery, Department of Surgery, Tri-Service General Hospital, 325 Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan, China.
De-Chuan
DC
Chan
Tzu-Ming
TM
Chang
Cheng-Jueng
CJ
Chen
Teng-Wei
TW
Chen
Jyh-Cherng
JC
Yu
Yao-Chi
YC
Liu
D000328:Adult; D000368:Aged; D004041:Dietary Fats / Q000008:administration & dosage; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016473:Gallbladder Emptying / Q000502:physiology*; D042882:Gallstones / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D014463:Ultrasonography
D004041:Dietary Fats