Digestive Diseases and Sciences

, Volume 32, Issue 12, pp 1337–1344 | Cite as

Effects of meal composition on gallbladder and gastric emptying in man

  • Robert S. Fisher
  • Elizabeth Rock
  • Leon S. Malmud
Original Articles


Cholecystogastric scintigraphy, utilizing [99mTc]HlDA to label the gallbladder contents and [111In]DTPA to label different meals, was utilized to determine the relationships between gallbladder and gastric emptying after meals of differing composition. Gallbladder emptying was determined in response to a multicomponent meal and to monocomponent fat, carbohydrate, and protein meals and in response to isotonic and hypertonic dextrose and isotonic and hypertonic saline. Also, the gallbladder emptying responses to equivalent multicomponent solid and liquid meals were compared. Significant gallbladder emptying was observed in response to the multicomponent meal and the monocomponent fat, carbohydrate, and protein meals. The most rapid and complete gallbladder emptying was seen with the multicomponent meal and the monocomponent fat meal. Significant gallbladder emptying was stimulated, not only by isotonic and hypertonic dextrose, but also by hypertonic saline. The gallbladder emptied more rapidly after a liquid than after a solid meal.

Key Words

cholecystogastric scintigraphy gallbladder emptying gastric emptying multicomponent meal monocomponent meal 


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  1. 1.
    LaRusso NF, Korman MG, Hoffman NE, Hofmann AF: Dynamics of the enterohepatic circulation of bile acids, Postprandial serum concentrations of conjugates of cholic acid in health, cholecystectomized patients, and patients with bile acid malabsorption. N Engl J Med 291:689–692, 1974Google Scholar
  2. 2.
    Ashkin JR, Lyon DT, Shull SD, Wagner CD, Soloway RD: Factors affecting delivery of bile to the duodenum in man. Gastroenterology 74:560–565, 1978Google Scholar
  3. 3.
    Englert E, Chin VS: Quantitation of human biliary evacuation with a radioisotope technique. Gastroenterology 50: 506–518, 1966Google Scholar
  4. 4.
    Rosenthall L, Shaffer EA, Lisbone R, Spellman SJ: Diagnosis of hepatobiliary disease by Tc-99m-HIDA cholecystography. Radiology 126:467–475, 1978Google Scholar
  5. 5.
    Spellman SJ, Shaffer EA, Rosenthall L: Gallbladder emptying in response to cholecystokinin. A cholescintigraphic study. Gastroenterology 77:115–120, 1979Google Scholar
  6. 6.
    Krishnamurthy GI: Radionuclide ejection fraction: A new technique for quantitative analysis of motor function of the human gallbladder. Gastroenterology 80:482–490, 1981Google Scholar
  7. 7.
    Fisher RS, Stelzer F, Rock E, Malmud LS: Abnormal gallbladder emptying in patients with gallstones. Dig Dis Sci 27:1019–1024, 1982Google Scholar
  8. 8.
    Edholm P: Gallbladder evacuation in the normal male induced by cholecystokinin. Acta Radiol 53:247–265, 1960Google Scholar
  9. 9.
    Park CY, Pae YS, Hong HS: Radiologic studies on emptying of the human gallbladder. Ann Surg 171:294–299, 1970Google Scholar
  10. 10.
    Brunner H, Northfield TC, Hofmann AF, Go VLW, Summerskill WHJ: Gastric emptying and secretion of bile acids, cholesterol, pancreatic enzymes during digestion: Duodenal perfusion studies in healthy subjects. Mayo Clin Proc 49: 851–860, 1974Google Scholar
  11. 11.
    Levitt MO, Bond J: Use of constant perfusion techniques in the non-steady state. Gastroenterology 73:1450–1453, 1977Google Scholar
  12. 12.
    Von Berge Henegouwen GP, Hofmann HF: Nocturnal gallbladder storage and emptying in gallstone patients and healthy subjects. Gastroenterology 75:879–885, 1978Google Scholar
  13. 13.
    Braverman DZ, Johnson ML, Kern F: Effects of pregnancy and contraceptive steroids on gallbladder function. N Engl J Med 302:362–364, 1980Google Scholar
  14. 14.
    Smith EM: Internal dose calculation for Tc-99m. J Nucl Med 6:231–251, 1965Google Scholar
  15. 15.
    Siegel JA, Wu RK, Knight LC, Zelac RE, Stern HS, Malmud LS: Radiation dose estimates for oral agents used in upper gastrointestinal disease. J Nucl Med 24:835–837, 1983Google Scholar
  16. 16.
    Snedecor GW, Cochran WG: Statistical Methods. Ames, Iowa, Iowa State University Press, 1967Google Scholar
  17. 17.
    Ivy AC, Oldberg EA: A hormone mechanism for gallbladder contraction and evacuation. Am J Physiol 86:599–613, 1928Google Scholar
  18. 18.
    Jorpes EJ, Mutt V, Olbe L: On the biologic assay of cholecystokinin and its dosage in cholecystography. Acta Physiol Scand 47:109–114, 1959Google Scholar
  19. 19.
    Jorpes EJ, Mutt V: Secretin, pancreozymin and cholecystokinin. Gastroenterology 36:377–385, 1959Google Scholar
  20. 20.
    Sturdevant RAL, Stern DH, Resin H, Isenberg JI: Effects of graded doses of octapeptide of cholecystokinin on gallbladder size in man. Gastroenterology 64:452–456, 1973Google Scholar
  21. 21.
    Herzog RJ, Nelson JA: The role of cholecystokinin in radiographic opacification of the gallbladder. Invest Radiol 11:440–448, 1976Google Scholar
  22. 22.
    Regan PT, Go VLW, DiMagno EP: Comparison of the effects of cholecystokinin octapeptide on pancreatic secretion, gallbladder contractions and plasma pancreatic polypeptide in man. J Lab Clin Med 96:743–740, 1980Google Scholar
  23. 23.
    Cameron AJ, Phillips SF, Summerskill WHJ: Effects of cholecystokinin, gastrin, secretin and glucagon on human gallbladder muscle,in vitro. Proc Soc Exp Biol Med 31:149–154, 1969Google Scholar
  24. 24.
    Hunt JN: Some properties of an alimentary osmoreceptor mechanism. J Physiol (London) 132:267–288, 1956Google Scholar
  25. 25.
    Hunt, JN: The duodenal regulation of gastric emptying. Gastroenterology 45:149–156, 1963Google Scholar
  26. 26.
    Heading RC, Tothill P, McLoughlin GP, Shearman DJC: Gastric emptying rate measurement in man. A double isotope scanning technique for simultaneous study of liquid and solid components of a meal. Gastroenterology 71:45–50, 1976Google Scholar
  27. 27.
    Fisher, RS, Malmud, LS, Bandini P, Rock E: Gastric emptying of a physiologic mixed solid-liquid meal. Clin Nucl Med 7:215–221, 1982Google Scholar

Copyright information

© Plenum Publishing Corporation 1987

Authors and Affiliations

  • Robert S. Fisher
    • 1
  • Elizabeth Rock
    • 1
  • Leon S. Malmud
    • 1
  1. 1.Department of Medicine and Diagnostic ImagingTemple University School of MedicinePhiladelphia

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