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GALLBLADDER EMPTYING IN MAN RELATED TO FASTING DUODENAL MIGRATING MOTOR CONTRACTIONS
Author(s) -
Toouli J.,
Buschell M.,
Stevenson G.,
Dent J.,
Wycherley A.,
Iannos J.
Publication year - 1986
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1986.tb01872.x
Subject(s) - medicine , gallbladder , duodenum , migrating motor complex , volume (thermodynamics) , motor activity , gastroenterology , endocrinology , cardiology , anatomy , physics , quantum mechanics
Animal studies have shown that the gallbladder (GB) empties partially during fasting in relation to phase II of the interdigestive motor cycle (IDMC). It has been assumed that in man the GB remains inert during fasting, although there have been no studies in which repeated sequential measurements of gallbladder volume have been made and related to the IDMC. In this study the possibility of linkage between the IDMC and GB volume has been examined in nine fasting human volunteers (five malesifour females). A multilumen constantly perfused manometry catheter was positioned in the duodenum and motor activity recorded continuously. Phase III of the IDMC was characterized by phasic contractions, with a frequency of 10–12/min for at least 2 min, which had a distal propagative pattern and were followed by a motor quiescence (Phase 1). GB volume was calculated at 15 min intervals from ultrasound measurements of the maximal length and diameter of the GB by the summation of cylinders method, and related to the time of onset of each phase III of the IDMC. In all nine subjects GB volume decreased prior to the onset of phase III and increased following its passage (P <0.01). GB volume decrese ranged between 6 and 56% of maximal GB volume (median 18%) and subsequent filling ranged from 14 to 53% (median 27%). The maximal volume decrcase occurred 30 min prior to the onset of phase III (P < 0.02). These studies have demonstrated that thc human GB empties partially during phase II of the IDMC. The physiological significance of this observation is uncertain, however. it strengthens the speculation that primary GB motility may have a role in determining thc content of GB bile and motility disorders may be a factor in the aetiology of GB disease.