Abstract
Measurement of gallbladder motility is a powerful research tool, but its value in
clinical practice is uncertain. Three main conditions have been investigated for potential
clinical application of this measurement. The first potential application is for identification
of patients at risk of recurrence following gallstone dissolution with medical therapy.
Results in this clinical setting are disappointing due to the low positive predictive
value for gallstone recurrence in sluggish gallbladder emptying. The second potential
application is for identification of obese patients at risk of gallstone formation
during rapid weight loss. In this condition, a high negative predictive value has
been reported for a normal gallbladder emptying pattern. The third potential application
is for patients with recurrent biliary colic and acalcolous gallbladder disease. The
diagnostic value of a provocative test involving intravenous cholecystokinin injection
as a method of identifying patients likely to benefit from cholecystectomy is uncertain,
partly as a consequence of non-standardized methodology. The balance of evidence reported
in this review suggests a low inherent value of measurement of gallbladder motility
in clinical practice. Acalcolous gallbladder disease is the clinical setting deserving
further investigation on the value of the cholecystokinin provocative test, but this
test needs to be standardized.
Keywords
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© 2003 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.
