Photo-optical observation of gallbladder motility in man

Abstract

Gallbladder motility was studied with a 16 mm slow speed cine-cholangiography. Subjects studied were twenty healthy adults, eight cases with biliary tract diseases and twelve patients with gastric diseases who underwent various gastrectomies.After “the four-day Telepaque test” intravenous drip infusion of contrast medium was performed. The cine-cholangiography was done by an image intensifier at a speed of one frame every 2 or 4 seconds. Thirty minutes after injection three yolks were given orally and observation was continued further for about 60 and 90 minutes. The cine films taken were observed repeatedly by screen projection at various speed. At the same time the size of the gallbladder were measured by means of planimeter and a ratio of the size of every 10 minutes to initial one was calculated. And contraction curve of the gallbladder was depicted on every case.The results obtained are as follows:1. The phenomenon of gallbladder contraction over 90 to 120 minutes was contracted into that of about 3 to 4 minutes by normal speed projection.2. By the intravenous drip infusion of contrast medium the size of the gallbladder was a little enlarged. And the yolk administration made the contraction of it about one half of the initial size within 40 minutes. All of these contraction curves never show the straight line but have 2 or 3 undulations in normal cholecystometric pattern.3. In cases with gallstone diseases the cholecystometric curves did not show the typical contraction pattern after the administration of yolks. The size of gallbladder was nearly the same as initial one in all process of contraction except one case with a large solitary cholesterol stone whose cholecystometric study revealed the pattern of rapid evacuation.4. In patients with gastric diseases before operation the cholecystometric curves showed the same pattern as normal.However, contraction curves showed the pattern which indicates the delayed evacuation after gastrectomies. Especially this phenomenon was remarkable in patients who underwent total or proximal gastrectomies. It is from the results conceivable that this delayed evacuation of the gallbladder after operation is due to vagotomy.