Abstract
Impaired gallbladder motility plays an important role in the pathogenesis of benign gallbladder disorders. Defective gallbladder muscle contraction is associated with supersaturated bile with cholesterol and with pregnancy due to high circulating levels of progesterone. These abnormalities result in bile stasis that facilitates gallstone growth. A defective gallbladder muscle contraction may also contribute to the pathogenesis of acute and chronic cholecystitis. In addition, an impaired gallbladder contraction may be the source of recurrent biliary colicky pain in patients with acalculus gallbladder disease. The gallbladders of these patients have an abnormal ejection fraction of less than 35% in response to an intravenous infusion of cholecystokinin (CCK). Although histology of the gallbladder wall is grossly normal, the muscle cells are functionally abnormal, with an impaired response to agonists that act on membrane and cytosolic receptors.
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Behar J: Physiology of the biliary tract. In Gastroenterology. Edited by Haubrich WS, Schaffner F, Berk JE. Philadelphia: W.B. Saunders; 1989:2554–2572.
Matsumoto T, Sarna SK, Condon RE, et al.: Canine gallbladder cyclic motor activity. Am J Physiol. 1988, 255:G409-G416.
Ura K, Sarna SK, Condon RE: Antral control of gallbladder cyclic motor activity in the fasting state. Gastroenterology. 1992, 102:295–302.
Behar J, Lee KY, Thompson WR, et al.: Gallbladder contraction in patients with pigment and cholesterol stones. Gastroenterology 1989, 97:1479–1484.
Moskowitz M, Min TC, Gavaler JS: The microscopic examination of bile in patients with biliary pain and negative imaging tests. Am J Gastroenterol. 1986, 81:329–333.
Pomeranz IS, Shaffer EA: Abnormal gallbladder emptying in a subgroup of patients with gallstones. Gastroenterology. 1985, 88:787–791.
Chen Q, Amaral J, Biancani P, et al: Excess membrane cholesterol alters human gallbladder contractility and fluidity. Gastroenterology, in press.
Lennard TW, Farndon JR, Taylor RM: Acalculus biliary pain: diagnosis and selection for cholecystectomy using the cholecystokinin test for pain reproduction. Br J Surg. 1984, 71:368–370.
Sorenson MK, Fancher S, Lang NP, et al.: Abnormal gallbladder nuclear ejection fraction predicts success of cholecystectomy in patients with biliary dyskinesia. Am J Surg. 1993, 166:672–674.
Smythe A, Majeed AW, Fitzhenry M, et al.: A requiem for the cholecystokinin test? Gut. 1999, 43:571–574.
Adams DB, Tarnasky PR, Hawes RH, et al.: Outcome after laparoscopic cholecystectomy for chronic acalculus cholecystitis. Am Surg. 1998, 64:1–5.
Amaral JF, Yu PR, Chen Q, et al.: Mechanisms of gallbladder muscle dysfunction in symptomatic stone free gallbladders [abstract]. Gastroenterology. 1996, 110:A1373.
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Behar, J. Clinical aspects of gallbladder motor function and dysfunction. Curr Gastroenterol Rep 1, 91–94 (1999). https://doi.org/10.1007/s11894-996-0005-9
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DOI: https://doi.org/10.1007/s11894-996-0005-9