Gallbladder function after endoscopic sphincterotomy—a dynamic ultrasound assessment

Abstract

There is controversy regarding the function of the gallbladder following endoscopic sphincterotomy (ES) for the treatment of gallstones. Using ultrasound to assess gallbladder volume, we evaluated gallbladder contractility in 34 patients (18 male, 16 female), mean age 73 years, who had ES and common bile duct (CBD) clearance a mean of 18 months earlier. In 16 patients gallbladder function could not be measured, either because the fasting gallbladder was small and contracted or because it contained gas. The remaining 18 patients (53%) had "normal" gallbladder contraction with a mean initial fasting volume of 30.3 ml and mean post fatty meal volume of 13.8 ml. 14 of these 18 patients had a repeat fasting volume which showed refilling in all except one. Those with a functioning gallbladder had had significantly smaller stones extracted from the CBD at the time of ES. A smaller or incomplete sphincterotomy may have been performed in these patients, therefore allowing some residual sphincter of Oddi function.