Clinical Research
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 14, 2008; 14(18): 2825-2831
Published online May 14, 2008. doi: 10.3748/wjg.14.2825
Decreased postprandial gallbladder emptying in patients with black pigment stones
Takakazu Sugo, Kenichi Hakamada, Shunji Narumi, Mutsuo Sasaki
Takakazu Sugo, Kenichi Hakamada, Shunji Narumi, Mutsuo Sasaki, Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan
Author contributions: Sugo T designed the research; Sugo T, Hakamada K and Narumi S collected the data; Sugo T and Hakamada K carried out the statistical analyses and organized the figures and tables; Hakamada K wrote the paper; and Sasaki M supervised the organization process.
Correspondence to: Kenichi Hakamada, MD, Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan. hakamada@cc.hirosaki-u.ac.jp
Telephone: +81-172-395079
Fax: +81-172-395080
Received: January 19, 2008
Revised: March 14, 2008
Published online: May 14, 2008
Abstract

AIM: To analyze gallbladder contractility in patients with black pigment stones (BPSs) and to compare this with patients with cholesterol stones (CSs) and healthy volunteers.

METHODS: The pattern of bile evacuation from the gallbladder was quantified by computer cholescintigraphy in 28 normal subjects, 22 patients with CSs and 14 with BPSs. The parameters of gallbladder contractility included ejection period (EP), ejection fraction (EF) and ejection rate (ER).

RESULTS: A significantly shorter EP was observed in patients with BPSs in comparison to those with CSs (t = 2.4, P < 0.05). EF in BPS patients significantly decreased in comparison to that in CS and normal subjects (t = 6.4, P < 0.0001; t = 2.1, P < 0.05). EF in CS patients also significantly decreased in comparison to that in normal subjects (t = -3.0, P < 0.005). Consequently, ER in patients with BPSs and CSs was significantly smaller than that in normal subjects (t = 3.1, P < 0.005; t = -3.5, P < 0.001). Moreover, in cases where postprandial reflux of a radioisotope into the common hepatic duct from the gallbladder was observed, EF and ER of either CS or BPS patients showed a significant reduction.

CONCLUSION: Bile evacuation from the gallbladder is reduced in patients with BPSs, in comparison to those with CSs and to healthy volunteers. Bile stagnation due to impaired gallbladder kinetics seems to be one of the predisposing factors for the development of BPSs.

Keywords: Black pigment stone, Cholescintigraphy, Gallbladder emptying, Ejection period, Ejection fraction, Ejection rate