Gallbladder Emptying during High-Dose Cholecystokinin Infusions Effect in Patients with Gallstone Disease and Healthy Controls

Abstract

Background: Impaired gallbladder emptying is a pathogenetic factor in gallstone formation. To test whether gallbladder motility can be improved by high-dose cholecystokinin (CCK), gallbladder emptying was measured sonographically in 21 patients with cholesterol gallstone disease and 6 healthy controls. Methods: The effects of CCK infusions of 0.06 IDU/kgmin (group A, n = 11) and 0.12IDU/kg/min (group B, n = 10) were compared with the response to a standard CCK infusion (0.02 IDU/kg/min). Controls received CCK at all infusion rates. Results: The ejection fraction was smaller after CCK infusion of 0.06 IDU/kg/min than after the standard stimulus (group A, 52 ± 10 versus 64 ± 10%, p < 0.05; controls, 66 ± 10 versus 91 ± 3%, p < 0.05). After infusion of 0.12 IDU/kg/min CCK ejection fractions decreased even more (group B, 44 ± 16 versus 65 ± 12%, p < 0.05; controls, 54 ± 12 versus 91 ± 3%, p <0.05). High-dose CCK infusions shortened the ejection period markedly, whereas the ejection rate remained unaltered. Conclusions: High-dose CCK does not improve gallbladder motility but blocks the ejection process early, leading to reduced gallbladder emptying in gallstone patients and healthy subjects.

Key Words:

• Cholecystokinin
• cholesterol gallstone disease
• gallbladder emptying
• ultrasonography