Decreased postprandial gallbladder emptying in patients with black pigment stones.
OBJECTIVE
To analyze gallbladder contractility in patients with black pigment stones (BPSs) and to compare this with patients with cholesterol stones (CSs) and healthy volunteers.


METHODS
The pattern of bile evacuation from the gallbladder was quantified by computer cholescintigraphy in 28 normal subjects, 22 patients with CSs and 14 with BPSs. The parameters of gallbladder contractility included ejection period (EP), ejection fraction (EF) and ejection rate (ER).


RESULTS
A significantly shorter EP was observed in patients with BPSs in comparison to those with CSs (t = 2.4, P < 0.05). EF in BPS patients significantly decreased in comparison to that in CS and normal subjects (t = 6.4, P < 0.0001; t = 2.1, P < 0.05). EF in CS patients also significantly decreased in comparison to that in normal subjects (t = -3.0, P < 0.005). Consequently, ER in patients with BPSs and CSs was significantly smaller than that in normal subjects (t = 3.1, P < 0.005; t = -3.5, P < 0.001). Moreover, in cases where postprandial reflux of a radioisotope into the common hepatic duct from the gallbladder was observed, EF and ER of either CS or BPS patients showed a significant reduction.


CONCLUSIONS
Bile evacuation from the gallbladder is reduced in patients with BPSs, in comparison to those with CSs and to healthy volunteers. Bile stagnation due to impaired gallbladder kinetics seems to be one of the predisposing factors for the development of BPSs.
Sugo
Takakazu
T
Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan.
Hakamada
Kenichi
K
Narumi
Shunji
S
Sasaki
Mutsuo
M
D000328:Adult; D000368:Aged; D001654:Bile Pigments / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D005704:Gallbladder / Q000378:metabolism / Q000503:physiopathology; D016473:Gallbladder Emptying / Q000502:physiology*; D042882:Gallstones / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period / Q000502:physiology*; D011877:Radionuclide Imaging
D001654:Bile Pigments