Ultrasonographic Studies of Gallbladder Emptying in Patients with Gallbladder Stone: With Parallel Studies of Gastric Emptying

利用超音波研究膽囊結石病人的胃與膽囊排空

鄭乃源(Nai-Yuan Cheng) ； 劉代鵬(Dai-Peng Liu) ； 廖麗瑛(Li-Ying Liao) ； 王朝欣(Chaur-Shine Wang) ； 劉正典(Jean-Dean Liu) ； 陳寶輝(Pao-Huei Chen)

《中華民國消化系醫學雜誌》 13卷1期 (1996/03) Pp. 1-12

https://doi.org/10.6557/GJTb.199603_13(1).0001

摘要

The present study is designed to observe simultaneously both gastric and gallbladder emptying by ultrasound in order to determine whether impaired gallbladder emptying is consequent on delayed gastric emptying. Twelve gallstone patients and eleven normal controls were required to eat a standard mixed solid and liquid meal after an overnight fasting for 8 hr. The cross sectional area of the gastric antrum was calculated by elliptical method. The gallbladder volume was computed in cubic centimeters by ellipsoid method. As a result, the mean fasting and 120 min gallbladder volumes in gallstone patients are greater than that of normal controls (18.8±1.8cm^3 vs. 10.9±1.2cm^3 and 11.3±2.4cm^3 vs. 1.7±0.7cm^3, respectively) (P＜0.05) . The mean ejection fraction of gallbladder in gallstone patients (35%±14%) is less than that in normal controls (85%±6%) (P＜0.05). On the other hand, the mean maximal and 120 min antral areas and the gastric emptying fractions are similar in gallstone patients (15.3±1.8cm^2, 8.8±1.6cm^2, 70%±7%) and normal controls (18.2±1.9cm^2, 9.0±1.0cm^2, 73%±6%) (P＞0.05). When the time-gallbladder volume curves are compared between patients and controls, statistically significant differences are found (P＜0.05). However, the gastric emptying curves are similar in patients and controls (P＞0.05). In our study, the gallbladder of gallstone patients exhibit: 1) increased fasting volume, 2) decreased fractional emptying, and 3) increased postprandial residual volume. In addition, when we test the gastric and gallbladder emptying simultaneously, we find that the gastric emptying of control subjects exerts a stronger influence on the gallbladder emptying than that of gallstone patients. Therefore, delayed gallbladder emptying of gallstone patients is not likely to be due to delayed gastric emptying. As a result, other factors such as impaired innervation, abnormal smooth muscle of gallbladder or increased resistance to gallbladder emptying may have played a certain role in impeding gallbladder emptying of gallstone patients.

關鍵字

超音波 ； 膽囊排空 ； 胃排空 ； 膽結石

並列摘要

The present study is designed to observe simultaneously both gastric and gallbladder emptying by ultrasound in order to determine whether impaired gallbladder emptying is consequent on delayed gastric emptying. Twelve gallstone patients and eleven normal controls were required to eat a standard mixed solid and liquid meal after an overnight fasting for 8 hr. The cross sectional area of the gastric antrum was calculated by elliptical method. The gallbladder volume was computed in cubic centimeters by ellipsoid method. As a result, the mean fasting and 120 min gallbladder volumes in gallstone patients are greater than that of normal controls (18.8±1.8cm^3 vs. 10.9±1.2cm^3 and 11.3±2.4cm^3 vs. 1.7±0.7cm^3, respectively) (P＜0.05) . The mean ejection fraction of gallbladder in gallstone patients (35%±14%) is less than that in normal controls (85%±6%) (P＜0.05). On the other hand, the mean maximal and 120 min antral areas and the gastric emptying fractions are similar in gallstone patients (15.3±1.8cm^2, 8.8±1.6cm^2, 70%±7%) and normal controls (18.2±1.9cm^2, 9.0±1.0cm^2, 73%±6%) (P＞0.05). When the time-gallbladder volume curves are compared between patients and controls, statistically significant differences are found (P＜0.05). However, the gastric emptying curves are similar in patients and controls (P＞0.05). In our study, the gallbladder of gallstone patients exhibit: 1) increased fasting volume, 2) decreased fractional emptying, and 3) increased postprandial residual volume. In addition, when we test the gastric and gallbladder emptying simultaneously, we find that the gastric emptying of control subjects exerts a stronger influence on the gallbladder emptying than that of gallstone patients. Therefore, delayed gallbladder emptying of gallstone patients is not likely to be due to delayed gastric emptying. As a result, other factors such as impaired innervation, abnormal smooth muscle of gallbladder or increased resistance to gallbladder emptying may have played a certain role in impeding gallbladder emptying of gallstone patients.

並列關鍵字

Ultrasound ； gallbladder emptying ； gastric emptying ； gallstone