Gallbladder Function Research Articles

Management of Uncomplicated Gallstones and Benign Gallbladder Disease

Gallbladder disease is one of the most common problems that the general surgeon will encounter. This comprehensive review discusses the management of uncomplicated gallstone disease, functional gallbladder disease, and gallbladder polyps. It provides indications for cholecystectomy in the asymptomatic patient. There is a thorough review of the diagnosis and management of symptomatic cholelithiasis, including special situations such as pregnancy and cirrhosis, and the latest evidence regarding routine versus selective cholangiography during cholecystectomy. This review also discusses the latest updates to the criteria for diagnosing functional gallbladder disease and sphincter of Oddi dysfunction. This review contains 6 figures, 6 tables, and 99 references. Key words: asymptomatic gallstones, biliary dyskinesia, cholangiography, gallbladder polyps, laparoscopic cholecystectomy, sphincter of Oddi dysfunction, symptomatic cholelithiasis

Effect of Albiglutide on Cholecystokinin-Induced Gallbladder Emptying in Healthy Individuals: A Randomized Crossover Study.

The glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) exenatide and lixisenatide reduce cholecystokinin (CCK)-induced gallbladder emptying in healthy subjects. It is unknown if all GLP-1 RAs share this effect; therefore, the effect of the GLP-1 RA albiglutide on gallbladder function was assessed. In this randomized, double-blind, 2-way crossover study, a single dose of subcutaneous albiglutide 50 mg or placebo was administered to 17 healthy subjects, and CCK-induced gallbladder contractility was measured by ultrasonography. CCK (0.003 μg/kg) was infused intravenously over 50 minutes on study day 4 (3 days after dosing, to coincide with albiglutide's expected time to maximum concentration). Gallbladder volume, ejection fraction, and the main pancreatic and common bile-duct diameters were measured before, during, and following CCK infusion. Gallbladder volume was significantly greater in the albiglutide vs placebo groups before, during, and after CCK infusion, and the mean difference from placebo increased numerically during CCK infusion. The area under the volume-effect curve was significantly greater with albiglutide (P = .029). Starting at the 30-minute CCK infusion time point, the gallbladder ejection fraction was significantly lower with albiglutide than placebo. Changes in pancreatic duct diameter and common bile-duct diameter were not significantly different between albiglutide and placebo. Similar incidences of adverse events were observed between the albiglutide and placebo treatment periods. No new albiglutide safety signals were detected, and no serious adverse events were reported. In conclusion, similar to other GLP-1 RAs, albiglutide decreased CCK-induced gallbladder emptying compared with placebo in healthy individuals. Clinical implications of the gallbladder effects are unclear at this time.

HIDA scan for functional gallbladder disorder: ensure that you know how the scan was done

Despite the increasing use of fatty meal (FM) as a substitute for cholecystokinin (CCK) in pain reproduction during hepato-imino-diacetic acid (HIDA) scan in functional gallbladder disorder, there are no studies comparing the differences between CCK and FM. The present study was to compare the efficacy of FM in comparison of CCK in FGBD application. Patients undergoing HIDA scans from August 2013 to May 2014 were divided into two groups: those undergoing CCK-stimulated HIDA scan versus FM-stimulated HIDA scan. These groups were compared according to demographics and HIDA results. Of 153 patients, 70 received CCK and 83 FM. There was no difference regarding age, gender, gallstones, gallbladder ejection fraction and time to visualization. However, significantly more of the patients receiving CCK than FM experienced pain reproduction (61% vs 30%, P<0.01). Stimulation of gallbladder contractility with a FM during HIDA is less than half as likely to reproduce biliary symptoms compared to CCK, despite similar ejection fractions and other parameters. It is essential that providers account for this difference when counseling patients regarding cholecystectomy for functional gallbladder disorder.

Evaluation of anti-diabetic effect and gall bladder function with 2-thio-5-thiomethyl substituted imidazoles as TGR5 receptor agonists

A novel series of 2-thio-5-thiomethyl substituted imidazoles was discovered to be potent TGR5 agonists that possessed glucose-lowering effects while inhibiting gall bladder emptying in mice.

Biliary Dyskinesia in Children: A Systematic Review.

Cholecystectomy rates for biliary dyskinesia in children are rising in the United States, but not in other countries. Biliary dyskinesia is a validated functional gallbladder disorder in adults, requiring biliary colic in the diagnosis. In contrast, most studies in children require upper abdominal pain, absent gallstones on ultrasound, and an abnormal gallbladder ejection fraction (GBEF) on cholecystokinin-stimulated cholescintigraphy for diagnosis. We aimed to systematically review existing literature in biliary dyskinesia in children, determine the validity and reliability of diagnostic criteria, GBEF, and to assess outcomes following cholecystectomy. We performed a systematic review following the PRISMA checklist and searched 7 databases including PubMed, Scopus, Embase, Ovid, MEDLINE, ProQuest, Web of Science, and the Cochrane library. Bibliographies of articles were screened for additional studies. Our search terms yielded 916 articles of which 28 were included. Three articles were manually added from searched references. We reviewed 31 peer-reviewed publications, all retrospective chart reviews. There was heterogeneity in diagnostic criteria and GBEF values. Outcomes after laparoscopic cholecystectomy varied from 34% to 100% success, and there was no consensus concerning factors influencing outcomes. The observational, retrospective study designs that comprised our review limited interpretation of safety and efficacy of the investigations and treatment in biliary dyskinesia in children. Symptoms of biliary dyskinesia overlapped with functional dyspepsia. There is a need for consensus on symptoms defining biliary dyskinesia, validation of testing required for diagnosis of biliary dyskinesia, and randomized controlled trials comparing medical versus surgical management in children with upper abdominal pain.

The treatment of chronic ear itching. Interdisciplinary approach to the problem

The article presents the data of observation and treatment of patients with chronic ear itching according to the author’s method performed in 104 patients aged 19–75 years over more than 10 years. The author monitors the long-term results. The objective is to improve the efficacy of treatment and diagnostics of the patients with chronic itching in the external auditory canal resulting in deformation of the auditory canal and concha, prevent the aggravation in the form of external bacterial and mycotic external otitis, improve the patients’ life quality. Patients and methods: all the patients have undergone ear, throat, nose examination; general blood test, general urine test; biochemical blood assay: ALT, AST, alkaline phosphatase, total bilirubin, GGTP, ultrasonic test of liver, pancreas and gall bladder, microscopic examination of the external auditory canal secretion and the secretion inoculation for microflora. The treatment regimen included peroral administration of cholagogue and hepatoprotective preparations (soya bean phospholipids, Silybum marianum) and topical application of antiallergic preparation into ear in the form of a gel – histamine H1 receptor antagonist (dimethindene maleate, diphenhydramine hydrochloride). Results: a significant intensity reduction or cessation of itching in the external auditory canal; a considerable decrease of frequency of the acute external bacterial or mycotic otitis relapse or absence thereof; restoration of ceruminous and sebacerous glands of the external auditory canal skin which results in regeneration of protective function of the external auditory canal skin cover; improvement of liver and gall bladder function; in a number of cases – cessation or reduction of genital itch. Conclusion. In the process of diagnostics and treatment appointment as well as for reaching the clinical efficacy of the treatment it is necessary to consider the role and pathological changes of the patient’s hepatobiliary system.

Cholecystolithotomy Combined Armillarisin A versus Cholecystectomy in Cirrhotic Portal Hypertension Patients with Symptomatic Cholelithiasis

To discover whether cirrhotic portal hypertension patients with symptomatic cholelithiasis would benefit from cholecystolithotomy combined with Armillarisin A in the authors hospital. Methods: Sixty-one patients with cirrhotic portal hypertension and symptomatic gallstone disease who underwent either cholecystolithotomy combined with Armillarisin A (group A) or cholecystectomy (group B) for cholelithiasis from Feb 2007 to March 2011 were retrospectively reviewed. These patients were undergoing simultaneous procedure for esophageal varices. The operation-relevant information, change of laboratory examination data, postoperative complications and symptoms were analyzed. Results: There were no significant differences between group A and group B in mean operative time, intraoperative blood loss, time to resume diet postoperatively and length of hospital stay (P 0.05). The hepatic function biochemical profile and Child-Pugh'™s score at 2 weeks and 1 month after operations were both altered significantly less in group A than in group B (ALT, 0.008, 0.011; AST, 0.006, 0.003; Child-Pugh'™s score, 0.010, 0.016, respectively). However, at 6 months postoperatively, the changes were not significant (P 0.05). Except for gallstone recurrence and wound infection, occurrences or development of postoperative complications including biliary fistula, liver failure and subphrenic infection showed significant differences between the two groups (P = 0.037, P = 0.041, P = 0.019, respectively). After a mean follow-up of 4.2 years, all patients remain alive. Twenty-seven patients in group A (93%) are free of biliary symptoms. Cholecystolithotomy combined with using Armillarisin A is a useful treatment for symptomatic gallstones in patients with cirrhotic portal hypertension who are at high risk for cholecystectomy. It preserves gallbladder function and reduces the possibility of liver failure; moreover the rate of recurrent gallstones are relatively low.

Decision-making patterns in managing children with suspected biliary dyskinesia.

AIMTo explore and to analyze the patterns in decision-making by pediatric gastroenterologists in managing a child with a suspected diagnosis of functional gallbladder disorder (FGBD).METHODSThe questionnaire survey included a case history with right upper quadrant pain and was sent to pediatric gastroenterologists worldwide via an internet list server called the PEDGI Bulletin Board.RESULTSDifferences in decision-making among respondents in managing this case were observed at each level of investigations and management. Cholecystokinin-scintigraphy scan (CCK-CS) was the most common investigation followed by an endoscopy. A proton pump inhibitor was most commonly prescribed treating the condition. The majority of respondents considered a referral for a surgical evaluation when CCK-CS showed a decreased gallbladder ejection fraction (GBEF) value with biliary-type pain during CCK injection.CONCLUSIONCCK infusion rate in CCK-CS-CS and GBEF cut-off limits were inconsistent throughout practices. The criteria for a referral to a surgeon were not uniform from one practitioner to another. A multidisciplinary team approach with pediatric gastroenterologists and surgeons is required guide the decision-making managing a child with suspected FGBD. ​

Species spectrum of microflora of upper digestive tract mucosa and its effect on the development of pathology in children

Aim. To study microbial landscape of duodenal mucosa and bile samples from children with disorders of the upper digestive tract. &#x0D; Methods. The study material included 69 biopsy samples of duodenal mucosa obtained during upper endoscopy and bile samples (106 samples) obtained at fractional duodenal sounding of 106 children. An expanded set of growth media (5% blood agar, Endo’s medium, Ploskireva’s medium and alkaline bile agar) was used followed by biochemical identification, that allows revealing a wide range of contamination with aerobic and facultative anaerobic microorganisms. &#x0D; Results. It was found that in children with isolated forms of chronic gastroduodenitis and functional gallbladder disorders the frequency of H. pylori detection was significantly higher compared to other children who have organic desease of biliary system in the form of chronic сholecystitis. &#x0D; Conclusion. Infection is the trigger mechanism for the development of combined pathology of the upper digestive tract and the biliary system; in organic cholepathies mixed infection combined with H. pylori infection is more common.

Impaired gallbladder function in patients after total gastrectomy

Background and aims: The incidence of gallstones and gallbladder sludge is higher in patients after total gastrectomy than in general population. Formation of gallstones after gastrectomy is multifactorial. Here, we investigate the changes in gallbladder and biliary tract functions by cholescintygraphy and monitored changes in cholecystokinin (CCK) release in long-term survivors after total gastrectomy for gastric carcinoma.Material and methods: Patients had undergone total gastrectomy for gastric carcinoma at least five years ago. The final study population consisted of 25 patients.Results: Eight patients had undergone cholecystectomy before or at the time of gastrectomy. Gallstone formation was observed in seven of the remaining 17 patients during follow-up (41%). Maximum uptake of radioactivity and gallbladder maximum uptake was significantly delayed in the gastrectomy group than in the control group. There was no significant difference in CCK levels after the overnight fasting and at 60 minutes after stimulation among patients with or without stones in situ compared with healthy volunteers, but 30 minutes after the energy-rich drink patients had higher CCK levels than the control group.Conclusions: In gastrectomy patients, technetium isotope visualisation of the gallbladder and time for maximum activity was significantly delayed. This may indicate impaired gallbladder function. On the contrary, CCK release was not impaired.

Functional Gallbladder Disorder

Objective: To shed light on the clinical presentation and approach to diagnosis. Introduction: Functional gallbladder disorder is a dysfunction in gallbladder motility, the exact etiology remains unclear. As in all gastrointestinal motility disorders the diagnosis of functional gallbladder disorder is a diagnosis of exclusion. It is estimated that 21% of females and 8% of males with biliary-like pain and a normal transabdominal gallbladder ultrasound have functional gallbladder disorder. Case: A 30 year old Caucasian female with no significant past medical history presented with recurrent right upper quadrant (RUQ) pain. The pain has been persistent for several months and was associated with nausea and vomiting. The patient was recently diagnosed with a small gastric ulcer for which she was taking dexlansoprazole. Despite taking the medication as prescribed for a month, her symptoms were not alleviated. The patient continued to have pain that interfered with her daily activities and resulted in multiple visits to the emergency room (ER) where she was treated symptomatically. On her last visit to the ER the patient had a typical biliary-type pain, her physical exam was positive for RUQ pain, but Murphy's sign was negative. Initial work up including liver and pancreas blood tests were normal. Transabdominal gallbladder ultrasound revealed no cholelithiasis, sludge or signs of acute cholecystitis. CT abdomen was unimpressive as well. The patient was admitted to the hospital to control her symptoms and to further investigate the cause of the pain. The Gastroenterology service was consulted and the patient was scheduled to undergo cholecystokinin (CCK)-stimulated cholescintigraphy. The cholescintigraphy revealed decreased appearance of gallbladder activity and a reduced gallbladder ejection fraction (GBEF) of 34%, subsequently the patient was diagnosed with functional gallbladder disorder and she underwent cholecystectomy. The patient's symptoms significantly improved after surgery. Conclusion: In the case of typical biliary-like pain, normal blood work and normal transabdominal gallbladder ultrasound, clinicians should have a high index of suspicion for functional gallbladder disease.

Impaired Gallbladder Motility and Increased Gallbladder Wall Thickness in Patients with Nonalcoholic Fatty Liver Disease.

Background/AimsNonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease worldwide. Along with the increase in the incidence of NAFLD and associated obesity, an increase in gallbladder disease (GD) has been noted. This has led to the identification of a new disease entity called fatty GD. There is a gap in the literature on the dynamics of gallbladder function in patients with NAFLD.MethodsAn observational case-control study, a total of 50 patients with biopsy proven NAFLD without gallbladder stone/sludge and 38 healthy comparison subjects were enrolled. Fasting, postprandial gallbladder volumes (PGV), gallbladder ejection fraction (GEF), and fasting gallbladder wall thickness (FGWT) were measured by real-time 2-dimensional ultrasonography.ResultsFasting gallbladder wall thickness, fasting gallbladder volumes and PGV were significantly higher in patients with NAFLD than control subjects (P < 0.001, P = 0.006, and P < 0.001, respectively). Gallbladder ejection fraction was significantly lower in the NAFLD group than the controls (P = 0.008). The presence of NAFLD was an independent predictor for GEF, PGV, and FGWT. Also, steatosis grade was an independent predictor for GEF, and GEF was significantly lower in the nonalcoholic steatohepatitis (NASH) subgroup than the controls.ConclusionsGallbladder dysfunction and increase in gallbladder wall thickness exists in asymptomatic (without stone/sludge and related symptoms) patients with NAFLD and are useful in identifying fatty GD. Measurement of these variables in NAFLD patients may be useful in identifying those at higher risk for GD.

Up-regulation of BSEP and MRP2 by Calculus Bovis administration in 17α-ethynylestradiol-induced cholestasis: Involvement of PI3K/Akt signaling pathway

Ethnopharmacology relevanceCalculus Bovis, also known as Niuhuang, is a rare traditional Chinese medicine that has been widely used in China for 2000 years in pharmacology for sedation, anti-spasm, relieving fever, diminishing inflammation and recovering gallbladder functions. Aim of the studyThis study aimed to investigate the choleretic potential and molecular responses in rats to Calculus Bovis (CB) administration after 17α-ethynylestradiol (EE)-induced cholestasis. Material and methodsCB (50 and 100mg/kg per day) was intragastrically (i. g.) given to experimental rats for five consecutive days in coadministration with EE (5mg/kg daily for five days, s.c.). The levels of serum biomarkers were determined biochemically. The histopathology of the liver tissue was evaluated. Expression of bile salt export pump (BSEP) and multidrug resistance-associated protein 2 (MRP2) were studied by western blot and immunohistochemical assay. The expression of Akt and phospho-Akt (pAkt) were also measured by western blot. ResultsIn response to EE, CB treatment significantly prevented an increase in serum levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyltransferase (GGT) and total bilirubin (TBIL). CB treatment also repaired tissue lesions caused by EE. Western blots showed that EE significantly decreased the protein expression of BSEP and MRP2. EE also dramatically increased levels of pAkt and decreased levels of Akt. Compared to the EE group, CB treatment increased levels of hepatic BSEP and MRP2 while pAkt levels decreased and Akt levels increased. Immunohistochemistry also indicated that EE decreased the expression of BSEP and MRP2. LY294002 is a selective PI3K inhibitor and showed similar beneficial effects as CB. Decreased expression of BSEP and MRP2 caused by EE were also prevented by LY294002 treatment. ConclusionCalculus Bovis administration can alleviate liver injury and up-regulate the expression of BSEP and MRP2 in 17α-ethynylestradiol-induced cholestasis by a mechanism that may involve inhibiting the activated PI3K/Akt signaling pathway.

Gallbladder and Sphincter of Oddi Disorders

The concept that motor disorders of the gallbladder, cystic duct and sphincter of Oddi can cause painful syndromes is attractive and popular, at least in the USA. However, the results of commonly performed ablative treatments (cholecystectomy and sphincterotomy) are not uniformly good. The predictive value of tests that are often used to diagnose dysfunction (dynamic gallbladder scintigraphy and sphincter manometry) is controversial. Evaluation and management of these patients is made difficult by the fluctuating symptoms and the placebo effect of invasive interventions. A recent stringent study has shown that sphincterotomy is no better than sham treatment in patients with post-cholecystectomy pain and little or no objective abnormalities on investigation, so that the old concept of sphincter of Oddi dysfunction (SOD) type III is discarded. ERCP approaches are no longer appropriate in that context. There is a pressing need for similar prospective studies to provide better guidance for clinicians dealing with these patients. We need to clarify the indications for cholecystectomy in patients with Functional Gallbladder Disorder (FGBD) and the relevance of sphincter dysfunction in patients with some evidence for biliary obstruction (previously SOD type II, now called "Functional Biliary Sphincter Disorder - FBSD") and with idiopathic acute recurrent pancreatitis.

Rome IV—Functional GI Disorders: Disorders of Gut-Brain Interaction

Rome IV—Functional GI Disorders: Disorders of Gut-Brain Interaction

Functional gallbladder disease: Operative trends and short-term outcomes

Due to increasing rates of functional gallbladder disease (FGBD), we used national data to compare rates, patient characteristics, and outcomes of cholecystectomy for FGBD with the more defined diagnosis of biliary colic. The American College of Surgeons National Surgical Quality Improvement Program was reviewed for elective cholecystectomies from 2005-2013. The proportion of cholecystectomies performed for FGBD was assessed over time using a 2-sided Cochran-Armitage test for trend. Cholecystectomy for FGBD was compared with that for biliary colic using univariate analysis, multivariable logistic, and Cox proportional hazard regressions. Of 156,322 patients undergoing cholecystectomy, 5,161 (3.3%) had FGBD. FGBD as an indication for cholecystectomy remained stable over time (3.4% in 2006 to 3.2% in 2013, P=.29). Compared with biliary colic, patients with FGBD were more likely <50years old, non-Hispanic white, female, and had a body mass index <25 (all P<.001), while comorbidities were similar (P>.05). While differences in outcomes were seen on univariate analysis, on multivariable analysis, only duration of stay was significantly less for FGBD than biliary colic. Surgery residents were involved in 61.2% of the biliary colic versus 53.9% of FGBD cases (P<.001). The rate of FGBD as an indication for cholecystectomy is not increasing overall, but cholecystectomy may be more commonly performed at nonacademic hospitals. While cholecystectomy for FGBD appears safe, the outcomes are comparable to cholecystectomy for biliary colic and thus are not without risk.

Postprandial gall bladder contraction seen under ultrasound to rule out non functioning gall bladder in patients of flatulent dyspepsia

Thirty patients with flatulent dyspepsia selected. Ultrasound examination pre and postprandial done. 26 had normal postprandial gall bladder contraction. 4 patients found to be having non functional gall bladder as it did not show postprandial contraction. They were advised to have oral cholecystography and one of these 4 patients was found to have stone impacted in neck of gall bladder.

Safety and effectiveness of percutaneous cholecystostomy in critically ill children who are immune compromised.

Acalculous cholecystitis is known to develop in critically ill patients without cystic duct obstruction. In the past, treatment for acalculous cholecystitis has been cholecystectomy; however, many children who are critically ill are Percutaneous cholecystostomy is likely the procedure of choice in this subgroup of patients. To assess the safety and effectiveness of percutaneous cholecystostomy in critically ill and immune-compromised children with acalculous cholecystitis. Retrospective review of immune-compromised and critically ill children who underwent percutaneous cholecystostomy between 2006 and 2013. Diagnostic imaging performed included ultrasound, CT and hepatobiliary scintigraphy. Every percutaneous cholecystostomy was performed using imaging guidance. Ten critically ill and immune-compromised children with acalculous cholecystitis underwent percutaneous cholecystostomy. Seven boys and 3 girls, ranging in age from 10months to 15years 8months, were treated. Six of the immune-compromised children had received a bone marrow transplant for leukemia (5 children) or severe combined immunodeficiency (SCID) (1 child), and ranged from 18 to 307days post bone marrow transplant at the time of their percutaneous cholecystostomy. Of the remaining four immune-compromised children with acalculous cholecystitis who underwent percutaneous cholecystostomy, two had leukemia, one had SCID and lymphoma, and the fourth was undergoing treatment for undifferentiated germ cell tumor. The 10 percutaneous gallbladder drains were placed using a transhepatic approach, except one unintentional transperitoneal approach. There were no complications. Three gallbladder drains were removed in Interventional Radiology. Those three patients had a return to normal gallbladder function and didn't require cholecystectomy. Two drains were removed during cholecystectomy and another as an outpatient. Four patients died in the hospital due to multiorgan system failure, with indwelling gallbladder drains. Percutaneous cholecystostomy is a safe procedure in immune-compromised and critically ill children with acalculous cholecystitis. Percutaneous cholecystostomy may obviate the need for future cholecystectomy.

Telocytes: New Players in Gallstone Disease.

Cholesterol gallstone disease is highly prevalent in Western countries, particularly in women and some specific ethnic groups. The mechanisms behind the formation of gallstones are not clearly understood, but gallbladder dysmotility seems to be a key factor that triggers the precipitation of cholesterol microcrystals from supersaturated lithogenic bile.Given that newly described interstitial cells, telocytes, are present in the gallbladder and they are located in close vicinity of smooth muscle cell and neural fibers possibly interfering with gallbladder motility or contractility, authors are trying to summarize the current knowledge on the role of telocytes with respect to disturbed gallbladder function in gallstone disease.

Functional Gallbladder Dyskinesia and Pathological Finding of Gallbladder Microlithiasis: Which Came First — The Chicken or the Egg?

Introduction: Functional gallbladder (GB) dyskinesia is a debilitating disorder. We have previously shown that a significant number of subjects with chronic dyspepsia and a negative gastrointestinal (GI) work up had functional GB dyskinesia, which is characterized by a low GB ejection fraction (GBEF). Functional GB dyskinesia is thought to be due to metabolic disorders such as bile supersaturated with cholesterol or as a result of a primary motility disorder. However, the definitive etiology remains unclear. We examined the association of GB dyskinesia and blood dyscrasia, hypercholesterolemia, obesity, diabetes mellitus, and pathological findings of microlithiasis in subjects who underwent cholecystectomy. Methods: We retrospectively studied 129 subjects whose symptoms could not be explained by findings on abdominal ultrasound and computed tomography scan, upper and lower GI endoscopy. We excluded subjects with incomplete data, radiological findings of cholelithiasis/choledocholithiasis, previous sphincterotomy, any biliary surgery, and ongoing prokinetic medications. Pathology specimens were studied in those patients diagnosed with GB dyskinesia (low GBEF). Statistical analysis was performed using chi-square for categorical variables and t-test for continuous variables with age-, gender-, and ethnicity-adjusted odds ratios. Unconditional logistic regression model was used to estimate 95% confidence intervals (CI). SAS 9.3 software was used to perform the statistical analysis. Results are shown as mean (range). Results: One hundred twenty nine subjects were included. Seventy two percent (93/129) were female and fifty three percent (69/129) were African American. Mean age of the subjects was 54 (range 15-96). Fifty two percent (68/129) of subjects were diagnosed with GB dyskinesia. Of these, 24% (16/68) had chronic cholecystitis, and 3% (2/68) had microlithiasis found in pathological specimens. On multivariate analysis, the presence of blood dyscrasias (p=0.60), hypercholesterolemia (p=0.60), and diabetes mellitus (p=0.70) were not statistically significant. No correlation was found among age, gender, ethnicity, BMI, and GB dyskinesia. Conclusion: Metabolic disorders such as blood dyscrasia, hypercholesterolemia, and diabetes mellitus were not associated with GB dyskinesia. However, we found that subjects with GB dyskinesia had chronic cholecystitis and microlithiasis, which was not detected by imaging studies. Larger studies are warranted to validate these findings.