Gallbladder Motility In Patients With Liver Cirrhosis And Gallstone Formation

Aims: To investigate the gallbladder motility in patients with liver cirrhosis and the relationship between gallbladder motility function and gallstone, then provide bases in choosing suitable method in the diagnosis of gallbladder motility disorder, prevention and cure liver cirrhosis combination gallstones. Materials and Methods: The study included two groups: 14 normal subjects, 62 patients with cirrhosis, 15 cirrhosis patients with gallstones, 47 cirrhosis patients without gallstone. Patients were divided into cirrhosis with gallstones and without gallstone through B ultrasound. Every normal subject received inquisition, physical examination, and B ultrasound in the condition of fasting. All normal subjects didn't have the history of liver disease, pancreas and biliary tract system diseases, without peptic ulcer, abdomen operation and diabetes mellitus history et al. There were no significances in age and sex between cirrhosis patients and normal subjects. All subjects received 99mTc-EHIDA hepatobiliary scintigraphy in nuclear medicine department of Beijing friendship hospital between June 2004 and February 2005. After an 8-12-hour fast, each subject was given 185MBq(5mCi) of 99mTc-EHIDA intravenously. 60mins after injection, every subject lies supine under a large-field γ-camera fitted with a low-energy parallel collimator. Serial hepatobiliary analog images were taken for 65mins at 1-min intervals. These patients ate a standard 200ml liquid fatty meal within 1-2mins in 3mins after acquisition. Two regions on interest (ROIs) were chosen: ROI1, over the entire gallbladder; ROI2, over the entire liver. Time-activity curves were generated for both ROIs and the counts were corrected for physical decay: latent period (LP), ejection period (EP), gallbladder ejection fraction (GBEF), and ejection rate (ER). Results: The image of liver 60mins after injection is clear with high background counts and the counts of gallbladder region are high in cirrhosis patients, the liver image of normal subjects is disappeared; there was radioactivity in gallbladder and intestinal track. The decrease velocity of liver radioactivity and the increase velocity of intestinal track are low in cirrhosis patients. 1. Significant differences in GBEF, LP and Ejection rate were found between 14 normal subjects and 58 cirrhosis patients. 2. Significant differences in incidence rate of gallbladder motility abnormal, thickness of gallbladder wall and serum TBA were found between 15 cirrhosis patients with gallstones and 47 cirrhosis patients without gallstone. 3. Significant differences in incidence rate of gallbladder motility abnormal and thickness of gallbladder wall and there was no significant difference in incidence rate of gallstones in different Child-Pugh score (Child-pugh A 7.7%and15.4%, B 19.0%and19.0%, C 24.2%and 46.4%). 4. There was no significant difference in incidence rate of gallstones and gallbladder motility abnormal between less than 40 years group, 40-60 years group and more than 60 years group. It is clear that the incidence rate of gallstones and gallbladder motility abnormal increased with the older of the patients. 5. There was no significant difference in incidence rate of gallstones and gallbladder motility abnormal between male and female group. It is clear that the incidence rates of gallstones and gallbladder motility in female group are higher than male group. Conclusions: The gallbladder motility function of cirrhosis patients is impairedwith the characteristic of impairment of GBEF and ER. The gallbladder motility function of cirrhosis with gallstones patients is impaired, and is relation to the thickness of gallbladder wall and serum TBA level. 99mTc-EHIDA hepatobiliary scintigraphy is a noninvasive, safety, valuable examine method in the aspect of motility function examination.