Brief Reports
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 1, 2004; 10(21): 3230-3233
Published online Nov 1, 2004. doi: 10.3748/wjg.v10.i21.3230
Gallbladder motility in patients with hepatic cirrhosis before and after portal azygous disconnection
Hong-Xu Jin, Shuo-Dong Wu, Xue-Feng Zhang, Xian-Ying Chen, Guo-Xu Zhang
Hong-Xu Jin, Shuo-Dong Wu, Xue-Feng Zhang, Xian-Ying Chen, Guo-Xu Zhang, The Second Department of General Surgery, Second Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
Xue-Feng Zhang, General Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, Liaoning Province, China
Xian-Ying Chen, Guo-Xu Zhang, Department of Nuclear Medicine, General Hospital of Shenyang Military Command, Shenyang 110016, Liaoning Province, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Shuo-Dong Wu, The Second Department of General Surgery, Second Hospital, China Medical University, 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. hongxujin@tom.com
Telephone: +86-24-83955058
Received: February 6, 2004
Revised: February 14, 2004
Accepted: February 21, 2004
Published online: November 1, 2004
Abstract

AIM: To determine and compare the effect of vagus nerve on gallbladder motility in patients with hepatic cirrhosis before and after portal azygous disconnection (PAD).

METHODS: PAD operation (or Hassab’s operation) was performed on 18 patients with portal hypertension, and anterior and posterior vagal trunks were cut. On d 3 before operation and d 10 after operation, 99mTc-EHIDA 185 MBq was administered intravenously to the patients, and scintigraphy was performed at 0.25 min/frame. A standard fat meal was administered 30 min after scintigraphy, and dynamic imaging was performed 60 min after the fat meal. Following appearance of the region of interest (ROI) in gallbladder, the time-activity curve of ROI was established. The following seven parameters were used: Radioactivity at 30 min after injection of 99mTc-EHIDA (RC 30min), bile emptying fraction (EF), bile emptying period (EP), emptying rate (ER), latent period (LP), latent period radiocounting increment (LI), and latent period radiocounting increment rate (LR).

RESULTS: The RC 30 min decreased significantly after operation, compared with that before operation (2 693.6 ± 2 406.9 vs 5 606.8 ± 2 625.4, P < 0.05). The radiocounting of gallbladder increased gradually during LP. LP after operation was significantly longer than that before operation (13.36 ± 5.92 vs 2.24 ± 1.48, P < 0.01). LI and LR after operation were significantly higher than those before operation (2 861.62 ± 028.3 vs 331.21 ± 421.02, and 113.42 ± 49.52 vs 7.57 ± 10.75, respectively, both P < 0.01). EP after operation was significantly shorter than that before operation (18.5 ± 6.3 vs 24.1 ± 6.4, P < 0.05). EF and ER after operation were significantly lower than those before operation (13.1 ± 5.4 vs 32.3 ± 16.3, and 0.7 ± 0.3 vs 1.4 ± 0.8, respectively, both P < 0.01).

CONCLUSION: PAD operation is a good clinical model in studying the effect of vagus on gallbladder motility. The gallbladder tension after PAD operation decreases significantly during the interdigestive phase. The latent period of gallbladder contraction prolongs and the motility weakens apparently after a standard fat meal. Human vagus influences the gallbladder motility, and cutting of the nerve inhibits the gallbladder motility.

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