Relation of gallbladder motility to viscosity and composition of gallbladder bile in patients with cholesterol gallstones.
OBJECTIVE
Increased viscosity and supersaturation of cholesterol in gallbladder bile, as well as an impaired motility of the gallbladder, are considered to be important factors in the pathogenesis of cholesterol gallstones. However, the relation of these parameters has not yet been determined.


METHODS
Bile viscosity (mPa s) was measured by rotation viscosimetry and the composition of gallbladder bile was determined using standard methodology. Gallbladder motility was calculated as ejection fraction in percent of total volume 45 min after a test meal using ultrasonography in patients with gallstones prior to elective cholecystectomy.


RESULTS
The study included 35 patients with cholesterol gallstones. Viscosity of gallbladder bile ranged between 0.9 and 12.5 mPa s (median 2.2 mPa s) and an ejection fraction of the gallbladder of 55.4 +/- 18.3% (mean +/- SD) was determined. No significant correlation (r = 0.19, p < 0.2) between the 2 parameters could be calculated. Analysis of the composition of gallbladder bile revealed a positive correlation of all components to biliary viscosity but not to the motility of the gallbladder, with the exceptions of a negative correlation (r = 0.39, p < 0.02) between mucin concentration and the ejection fraction at 45 min after the test meal.


CONCLUSIONS
The motility of the gallbladder appears to be unrelated to the viscosity of gallbladder bile or gallbladder bile composition. The negative correlation between the ejection fraction of the gallbladder and mucin concentration of gallbladder bile suggests that chronic inflammation of the gallbladder wall is associated with both an impaired motility of the gallbladder and increased mucin release into gallbladder bile.
Gründel
Denis
D
Department of Medicine II, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany.
Jüngst
Christoph
C
Straub
Gundula
G
Althaus
Rupert
R
Schneider
Berthold
B
Spelsberg
Fritz W
FW
Hüttl
Thomas P
TP
del Pozo
Reginald
R
Jüngst
Dieter
D
Neubrand
Michael
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000737:chemistry / Q000502:physiology*; D017081:Cholecystectomy, Laparoscopic; D002784:Cholesterol / Q000032:analysis; D005260:Female; D016473:Gallbladder Emptying / Q000502:physiology*; D042882:Gallstones / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D014783:Viscosity
D002784:Cholesterol