Skip to main content
SpringerLink
Log in

Gallbladder dyskinesia in chronic acalculous cholecystitis

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

To test the hypothesis that there is an early stage of cholesterol gallstone formation in man characterized by symptoms of chronic cholecystitis, poor gallbladder emptying, and biliary cholesterol crystals, we studied cholecystokinin-stimulated gallbladder emptying by DISIDA scintigraphy and examined bile for cholesterol crystals in symptomatic patients with normal oral cholecystography and gallbladder sonography. Of 36 patients studied, 16 had biliary cholesterol crystals; their mean 30-min gallbladder ejection fraction was 25.9±14.8%. Among the 20 patients without crystals, the mean ejection fraction was 60.3±23.3%. Fifteen patients, 11 with crystals and four without, had cholecystectomy because of persistent symptoms. All with crystals preoperatively and three without had chronic cholecystitis histologically. One patient without crystals had normal histology. We conclude that poor gallbladder contractility, well-established as an etiologic factor in animal models of cholesterol cholelithiasis, is now linked to acalculous cholecystitis, an early stage of human cholesterol cholelithiasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pitt HA, Doty JE, DenBesten L, Kuchenbecker SL: Stasis before gallstone formation: altered gallbladder compliance or cystic duct resistance? Am J Surg 143:144–149, 1982

    Google Scholar 

  2. Doty JE, Pitt HA, Kuchenbecker S, Porter-Fink V, DenBesten L: Role of gallbladder mucus in the pathogenesis of cholesterol gallstones. Am J Surg 145:54–59, 1983

    Google Scholar 

  3. Fridhandler TM, Davison JS, Shaffer EA: Defective gallbladder contractility in the ground squirrel and prairie dog during the early stages of cholesterol gallstone formation. Gastroenterology 85:830–836, 1983

    Google Scholar 

  4. Wise WE, LaMorte WW, Matolo NW, Birkett DH, Williams LF: Cholesterol diet alters the guinea pig gallbladder contractile response. Gastroenterology 80:1317, 1981 (abstract)

    Google Scholar 

  5. Foss DC, Laing RR: Detection of gallbladder disease in patients with normal oral cholecystogram: Results using a simplified biliary drainage technique. Am J Dig Dis 22:685–689, 1977

    Google Scholar 

  6. Sedaghat A, Grundy SM: Cholesterol crystals and the formation of cholesterol gallstones. N Engl J Med 302:1274–1277, 1980

    Google Scholar 

  7. Shaffer EA, McOrmond P, Duggan H: Quantitative cholescintigraphy: Assessment of gallbladder filling and emptying and duodenogastric reflux. Gastroenterology 79:899–906, 1980

    Google Scholar 

  8. Krishnamurthy GT, Bobba VR, Kingston E: Radionuclide ejection fraction: A technique for quantitative analysis of motor function of the human gallbladder. Gastroenterology 80:482–490, 1981

    Google Scholar 

  9. Griner PF, Mayewski RJ, Mushlin AI, Greenland P: Selection and interpretation of diagnostic tests and procedures. Ann Intern Med 94:553–600, 1981

    Google Scholar 

  10. Pomeranz IS, Davison JJ, Shaffer EA:In vitro effects of pancreatic polypeptide and motilin on the contractility of the human gallbladder. Gastroenterology 82:1152, 1982 (abstract)

    Google Scholar 

  11. Carey MC, Small DM: The physical chemistry of cholesterol solubility in bile. J Clin Invest 61:998–1026, 1978

    Google Scholar 

  12. Holan KR, Holzbach RT, Hermann RE, Cooperman AM, Claffey WJ: Nucleation time: A key factor in the pathogenesis of cholesterol gallstone disease. Gastroenterology 77:611–617, 1979

    Google Scholar 

  13. Griffen WO Jr, Bivins BA, Rogers EL, Shearer GR, Liebschutz D, Lieber A: Cholecystokinin cholecystography in the diagnosis of gallbladder disease. Ann Surg 191:636–640, 1980

    Google Scholar 

  14. Dunn FH, Christensen EC, Reynolds J, Jones V, Fordtran JS: Cholecystokinin cholecystography. JAMA 228:997–1003, 1974

    Google Scholar 

  15. Nathan MH, Newman A, Murray DJ, Camponovo R: Cholecystokinin cholecystography. Am J Radiol 110:240–251, 1970

    Google Scholar 

  16. Fisher RS, Stelzer F, Rock E, Malmud LS: Abnormal gallbladder emptying in patients with gallstones. Dig Dis Sci 27:1019–1024, 1982

    Google Scholar 

  17. Krishnamurthy GT, Bobba VR, Kingston E, Turner F: Measurement of gallbladder emptying sequentially using a single dose of Tc-99m-hepatobiliary agent. Gastroenterology 83:773–779, 1982

    Google Scholar 

  18. Rhind JA, Watson L: Gallstone dyspepsia. Br Med J 1:32, 1968

    Google Scholar 

  19. Gunn A, Keddie N: Some clinical observations on patients with gallstones. Lancet 2:239–241, 1972

    Google Scholar 

  20. Gracie WA, Ransohoff DF: The natural history of silent gallstones. N Engl J Med 307:798–800, 1982

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Nuclear Medicine, Pathology and Surgery, State University of New York at Stony Brook, Story Brook, New York

    William R. Brugge MD, Douglas L. Brand MD, Harold L. Atkins MD, Bernard P. Lane MD & William G. Abel MD

Authors
  1. William R. Brugge MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Douglas L. Brand MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Harold L. Atkins MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bernard P. Lane MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. William G. Abel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brugge, W.R., Brand, D.L., Atkins, H.L. et al. Gallbladder dyskinesia in chronic acalculous cholecystitis. Digest Dis Sci 31, 461–467 (1986). https://doi.org/10.1007/BF01320308

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01320308

Keywords

Search

Navigation