Ultrasonographic evaluation of gallbladder dynamics in normal subjects and cholecystolithiasis.

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Gallbladder dynamics after ingestion of dried-egg meal or intramuscular injection of caerulein was investigated by real time ultrasonography in 23 patients with asymptomatic cholecystolithiasis, 16 patients with symptomatic cholecystolithiasis and 52 normal controls.Gallbladder emptying and refilling were evaluated by time-contractile ratio from maximal gallbladder area of ultrasonogram at 10 minute intervals during 2 hours after administration of stimulant. Peak contractile ratio was 51.2±9.2% in normal controls, 31.7±12.2% in asymptomatic cholecystolithiasis and 16.62±8.7% in symptomatic cholecystolithiasis at 50min after ingestion of dried-egg meal. Patients with asymptomatic cholecystolithiasis selected for this study all had normal thickness of gallbladder wall in ultrasonogram, normal opacificity in oral cholecystogram and no inframmatory reaction in chemical findings. In spite of this fact, those of contractility and refilling activity in asymptomatic cholecystolithiasis were significantly decreased compared with normal controls. Symptomatic cholecystolithiasis showed further significant decrease of contractility and refilling activity in comparison with asymptomatic cholecystolithiasis.These findings presumably were resulted from not only gallbladder dysfunction but also Oddi sphincter dysfunction. It is suggested that such systemic vesicosphincter dysfunction influence gallstone formation.
財団法人日本消化器病学会の論文