Short-term ursodeoxycholic acid treatment improves gallbladder bile turnover in gallstone patients: a randomized trial.
Ursodeoxycholic acid (UDCA) prevents in vitro gallbladder (GB) muscle damage caused by acute cholecystitis and reduces risk of biliary pain and complications in gallstone (GS) patients. These effects could be partially explained by the improved GB bile turnover.


OBJECTIVE
To assess the effect of short-term UDCA treatment on GB motility and bile turnover.


METHODS
Ultrasonographic (US) assessment of GB volumes was performed in 16 GS patients, in the postprandial phase, for 90 min with a time sampling of 1 min, before and after 30 days of UDCA (10 mg kg(-1) die(-1)) or placebo, randomly assigned. US data were analysed with statistical tools and with computer fluido-dynamic (CFD) software Fluent(TM) to simulate GB bile flow.


RESULTS
After therapy, fasting volume (FV) increased from 21.6 +/- 9 to 28.2 +/- 12 mL (p < 0.001) while the ejection fraction (EF) remained unchanged (44.5 +/- 17% vs 45.1 +/- 20%; p: ns). Volumes before and after treatment were poorly correlated (0.02 < r < 0.35), unlike those in placebo patients (r > 0.6). The average GB volume was increased in 7 out of 10 patients following UDCA (range 7-67%). CFD analysis supports the finding of improved bile flow after treatment.


CONCLUSIONS
Unlike results of conventional US parameters of GB motility, CFD analysis shows that UDCA improves GB bile turnover in GS patients.
Guarino
M P
MP
Department of Digestive Disease, University Campus Bio Medico, Rome, Italy.
Carotti
S
S
Sarzano
M
M
Alloni
R
R
Vanni
M
M
Grosso
M
M
Sironi
G
G
Maffettone
P L
PL
Cicala
M
M
D000328:Adult; D000368:Aged; D001646:Bile / Q000187:drug effects / Q000378:metabolism / Q000502:physiology*; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D005215:Fasting; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D042882:Gallstones / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D016896:Treatment Outcome; D014463:Ultrasonography; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D002756:Cholagogues and Choleretics; D010919:Placebos; D014580:Ursodeoxycholic Acid