Study On Association Of Cholecystokinin, Motilin, Gallbladder Contraction Function With Gallstone And Postcholecystectomy Syndrome

Objective: To study the relationship between the cholecystokinin (CCK), motilin (MTL), gallbladder contraction function and gallstone, postcholecystectomy syndrome (PCS).Methods: 20 cases of healthy individuals (control group) and 42 cases of patients with gallstone accepted selective cholecystectomy (patient group) were chosen. B-mode ultrasonography was adopted to measure gallbladder wall thickness, gallbladder maximum diameter(L), the maximum transverse diameter(W) and anteroposterior diameter(H), gallbladder volume (V) was calculated according to Dodds formula (V= 0.52×L×W×H). Gallbladder volume was checked under starvation condition, at 15 min, 30 min, 45 min, 60 min, 75 min, 90 min after fat diets; the minimum volume was chosen as residual volume (RV). The evacuation volume (EV=FV-RV), Gallbladder emptying rate (E= EV/FV×I00%) and Gallbladder residual factor (RF=1-E) were calculated. Patient group were divided into "normal" gallbladder contraction group (n=10) and "weakening" gallbladder contraction group (n=32) according to the average RF+2SD (42.05%) of control group. 4ml peripheral venous blood was collected from all control group patients, 1 day preoperative and 2 weeks postoperative in patient group, 4℃3500rpm×10min, stored at -70℃. CCK, MTL level were measured by Enzyme-linked immunosorbent assay. All patients got postoperative follow-up , and incidence of postoperative PCS were calculated.Results:1. Gallbladder wall thickness and emptying efficiency were significantly different between patient group and control group (P<0.01).2. There is significant negative correlation between gallbladder emptying efficiency and gallbladder wall thickness in patient group (r=-0.789, P=0.000),while there was no significant correlation between them in control group (r=-0.151, P=0.526);3. The incidence of postoperative PCS is higher in "normal" gallbladder contraction group than in "weakening" gallbladder contraction group (P <0.05);4. The preoperative fasting plasma CCK and MTL were higher in patient group than those in control group(P <0.05);There were no statistical significances to the CCK before and after surgery(P>0.05), and the level of MTL became lower after surgery in patient group (P <0.05);5. The level of CCK and MTL in "weakening" gallbladder contraction group before and after surgery was higher than those in "normal" gallbladder contraction group (P<0.05).Conclusion1. It appeared closed relationship between gallbladder contraction function, level of CCK, MTL and presence of gallbladder stones and PCS.2. There was a higher PCS incidence for the "normal" gallbladder contraction group compared with "weakening" gallbladder contraction group;It is possible to assess the gallbladder contraction function by measuring gallbladder wall thickness.