Effect of sequential administration of an opioid and cholecystokinin on gallbladder ejection fraction: brief communication.
This study was undertaken to test the effect of sequential administration of an opioid and intravenous cholecystokinin (CCK) on gallbladder ejection fraction.


METHODS
Forty-nine patients who had received an opioid underwent quantitative cholescintigraphy with octapeptide of CCK (CCK-8). Gallbladder ejection fraction and CCK-8-induced paradoxical filling were calculated.


RESULTS
In the basal state, more of the hepatic bile entered the gallbladder (67%) than the small intestine (33%). After CCK-8 infusion, gallbladder ejection fraction was low in 37 (76%) of 49 patients and normal in 12 (24%). All 5 types of opioids lowered ejection fraction. CCK-induced paradoxical filling of the gallbladder was noted in 7 patients, but only one showed paradoxical filling of greater than 20% and none had a normal gallbladder ejection fraction. The lowering effect of opioids on gallbladder ejection fraction may last as long as 18 h after intake.


CONCLUSIONS
CCK-8 produced a normal gallbladder ejection fraction in 24% of patients who had received an opioid and thus could exclude both acute and chronic cholecystitis during a single hepatobiliary study.
Krishnamurthy
Shakuntala
S
Nuclear Medicine Department, Tuality Community Hospital, Hillsboro, Oregon 97123, USA.
Krishnamurthy
Gerbail T
GT
D016477:Artifacts; D002764:Cholecystitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002766:Cholecystokinin / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000187:drug effects*; D016473:Gallbladder Emptying / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D011877:Radionuclide Imaging
D004338:Drug Combinations; D009294:Narcotics; D002766:Cholecystokinin