Ultrasound examination shows disturbed proximal gastric function in symptomatic gallstone patients with dyspepsia and improvement after cholecystectomy--gallstones and gastric emptying.
OBJECTIVE
The aim of our study was to examine gastric function, gallbladder emptying, and dyspepsia in symptomatic gallbladder stone patients (SGBS) to see if a motility disorder, expressed by gastric function and gallbladder emptying, may cause dyspepsia in SBGS.


METHODS
Gastric function and gallbladder emptying in 21 SGBS referred for surgical treatment were measured by ultrasound after ingestion of 500 ml of a meat soup (bouillon). Dyspeptic symptoms were simultaneously recorded on a Visual Analog Scale (VAS). The patients were re-examined 10 months after cholecystectomy. Hospital staff (n = 14) served as control subjects (C).


RESULTS
In SGBS, the frontal diameter of the proximal stomach was wider than in C at both 10 minutes (55.7 vs. 48.3 mm; p = 0.053) and 20 minutes (49.3 vs. 39.5 mm; p = 0.002), and the sagittal area of the proximal stomach was larger at 10 minutes (25.0 vs. 20.9 cm (2); p = 0.03). The postprandial frontal diameter decreased significantly after cholecystectomy (immediately after the meal: 51.3 mm; p = 0.03, at 10 minutes: 47.6 mm; p = 0.05, and at 20 minutes: 39.1 mm; p = 0.004). Twenty minutes after meal ingestion, gallbladder emptying was significantly less in SGBS than in C with a mean (SD) emptying of 20 % (17) versus 33 % (18); p < 0.04. In the fasting state, SGBS felt more hunger than C (VAS 67 mm vs. 39 mm; p = 0.03). After cholecystectomy, the feeling of hunger decreased (VAS 27 mm; p = 0.01).


CONCLUSIONS
SGBS had a wider proximal stomach and more hunger in the fasting state than C. After cholecystectomy the proximal stomach function and the hunger score improved. Our results suggest a physiological link between symptomatic gallstone disease and dyspepsia expressed by impaired proximal gastric function.
Berhane
T
T
Department of Surgery, Stavanger University Hospital, PO Box 8100, N-4068 Stavanger, Norway. tewelde.berhane@broadpark.no
Hausken
T
T
Olafsson
S
S
Søndenaa
K
K
D000328:Adult; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000601:surgery*; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging*; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D013270:Stomach / Q000000981:diagnostic imaging*; D016896:Treatment Outcome; D014463:Ultrasonography