Gastro-oesophageal and bile reflux--simultaneous quantitative assessment with gastric and gallbladder emptying evaluation: clinical applicability of a new computerized gammagraphic method

Increased prevalence of gallstone disease and impaired gallbladder motility in patients with Barrett's esophagus

The prevalence of gallstones in patients with Barrett's esophagus (BE) and their gallbladder motility relative to that of healthy volunteers and GERD patients without BE were investigated. Of the 707 patients reviewed, 203 (125 males and 78 females) had BE. The prevalence of gallstones was significantly higher in the patients with BE than in those without BE (34 vs. 20%, respectively). The gallbladder functions of 22 patients with GERD, 27 patients with BE and 21 healthy volunteers were assessed by ultrasonography before and after a test meal. The patients with BE had significantly higher fasting volume and residual volume, but lower ejection volume, ejection fraction and ejection rate values than those of the healthy controls. None of the ultrasonographic parameters of patients without BE were significantly different from those of the controls. Patients with BE have a more complex gastrointestinal motility disorder that involves the gallbladder, and this makes this subset of patients with GERD more prone to gallstone disease.

Evidence of impaired gallbladder function in patients with liver cirrhosis by quantitative radionuclide cholescintigraphy

OBJECTIVE

The aim of this study was to understand gallbladder function in liver cirrhosis.

METHODS

Gallbladder function was measured in 45 patients with liver cirrhosis by Tc-99m-labeled imino-diacetic acid analog cholescintigraphy. Gallbladder function was represented by the filling fraction and the ejection fraction (EF). The patients were divided into three groups, based on cirrhotic severity, using the modified Child's classification: A = good, B = fair, and C = poor. Fifteen normal control subjects were selected for comparison.

RESULTS

There were no significant differences in filling fraction among all of the study groups. Normal controls had significantly higher 60-min EF values than did liver cirrhosis patients. Among the liver cirrhosis patients, class A patients had the highest EF values, and class C patients had the lowest EF values.

CONCLUSIONS

We found that liver cirrhosis may significantly impair the gallbladder emptying, based on the evidence of quantitative Tc-99m-labeled imino-diacetic acid analog cholescintigraphy findings.