Ultrasonographic study of gallbladder motility in patients with diabetes mellitus and autonomic neuropathy

Abstract

Aim: Ultrasonographic assessment of gallbladder motility in patients with diabetes mellitus and autonomic neuropathy, having treatment with gabapentinum. Patients and methods: 30 patients with type II diabetes mellitus with various symptoms of autonomic neuropathy undertook this clinical study consisting of treatment with gabapentinum with initial dose of 3×300mg/day, with increasing doses till 3600mg/day for 6 months. They've got no previous gastric surgery, vagal denervation, or gallstones, sex ratio was:M/W=19/11, mean age=65.32±9.78 years, body mass index=33.44±5.51kg/m2. They also didn't receive associated treatment with prokinetic agents. We assess the gallbladder motility response related to this medication. Patients were examined by transabdominal ultrasonography with a 3.5MHz convex array probe, before and after the treatment. We calculated the gallbladder initial and residual volume with ellipsoid method and gallbladder ejection fraction. in fasting state and 30 minutes after a cholecystokinetic meal. An ejection fraction bellow 60% was considered pathological. Results: Before therapy the group of diabetic patients with neuropathy had a mean gallbladder ejection fraction=31.10%±3.98, showing a constant low rate of gallbladder emptying. After treatment the mean gallbladder ejection fraction was 49.59%±5.11, representing an elevation of gallbladder ejection fraction with 18.49%±1.13%, and an improving of gallbladder motility. Conclusions: Ultrasonography examination provided us with data concerning gallbladder motility disorders, represented by delaying of gallbladder emptying and decreasing the gallbladder ejection fraction. According to our results after treatment with gabapentinum diabetic patients showed a slightly improvement of gallbladder motility with promising clinical outcome regarding the dyspeptic complains and other related risk factors.