INTRAMUSCULAR SINCALIDE FOR CHOLECYSTOKINESIS DURING CHOLECYSTOSONOGRAPHY – A STUDY IN NORMAL VOLUNTEERS

Abstract

Gray scale ultrasonography has been shown to be quite accurate in the evaluation of cholelithiasis. The role of ultrasound in patients with suspected acalculous cholecystitis, cholestasis, biliary sludge or biliary dyskinesia has not been determined. It has been shown by ultrasound that the gallbladder will not contract if there is obstruction in either the cystic or common bile duct. The ability to show normal gallbladder contraction using ultrasonography may prove useful in the evaluation of a number of the above conditions. Prior to starting a clinical evaluation a double blind cross over study in 20 normal volunteers was performed to determine normal gallbladder contraction. Each subject received an intramuscular injection of 0.1 and 0.4 mgc/kg of Sincalide (C8–CCK). Using a standard commercially available gray scale ultrasound unit the gallbladder was scanned in both transverse and longitudinal planes every 10 minutes for 50 minutes after C8–CCK injection. Gallbladder contraction was determined using maximum length, maximum width, area, and volume. The 0.4 dose produced a 60% mean decrease in size compared to only a 15% decrease in size for the 0.1 dose (p < 0.001). All patients receiving the 0.4 dose had at least a 20% decrease in size. Maximum contraction occurred at 30 minutes and most gallbladders partially refilled by 50 minutes. Only minimal side affects were noted following the administration of either dose of C8–CCK. Based on these results we recommend using the 0.4 mgc/kg dose for clinical studies. The technique is currently being evaluated in a clinical protocol. Problems with measuring change gallbladder size will be discussed. Supported by E.R. Squibb – #8062–31.