The effect of gastrectomy on cholecystokinin (CCK) release and gallbladder contraction in patients with early gastric cancer--preliminary report
Huang, Y.S.; Huang, T.J.; Inoue, K.; Hosotani, R.; Fuchigami, A.; Kogire, M.; Tobe, T.; Rayford, P.L.
Gaoxiong Yi Xue Ke Xue Za Zhi 5(6): 330-334
1989
ISSN/ISBN: 0257-5655 PMID: 2778868 Document Number: 340974
Gastrectomy has been implicated in cholelithiasis. Impaired gallbladder motor function after the operation has been thought to be one of the major mechanisms. This study was undertaken to determine the effect of gastrectomy on release of cholecystokinin and contractile motility of gallbladder in five patients with early gastric cancer. After 14 hours fast, the gallbladder area was estimated by ultrasonography every 10 minutes for 120 minutes both before and after oral administration of 200 ml of Clinimeal. Blood samples were collected simultaneously via a peripheral vessel for measurement of plasma CCK levels by radioimmunoassay. Gallbladder contraction correlated well with the elevation of plasma CCK levels indicating that CCK might be one of the major factors governing gallbladder contraction both in pre- and post-gastrectomized conditions. Compared with preoperative cases, the postgastrectomized patients showed a significantly exaggerated postprandial response of CCK release in the initial 60 minutes, however, their gallbladder, responding to rapid reduction of plasma CCK levels, refilled significantly earlier. Postprandial rapid gastric emptying was thought to be related to the exaggerated postprandial CCK release, and the early refilling of the gallbladder might be attributed to the indefinite vagal or sympathetic denervation that might occurs during the necessarily wide lymph node dissections for gastric cancer operations.