The relationship between in vivo emptying of the gallbladder, biliary pain, and in vitro contractility of the gallbladder in patients with gallstones: Is biliary colic muscular in origin?

Background: This study sought to determine whether there is a positive correlation between gallbladder emptying, biliary pain, and in vitro contractility. Methods: Ultrasound measurements were carried out on 25 gallstone patients. The response of gallbladder strips to 1.75*10^-11 to 5.25*10^-7 M cholecystokinin-8 was recorded. In a second study 23 patients filled in pain questionnaires, and in vitro studies were again carried out. Results: Of five patients with no gallbladder emptying, four had in vitro contraction. Overall, a significant, positive linear correlation was found (P < 0.0001). In the second study in vitro contractility showed a positive linear correlation with pain. Conclusion: Gallbladder emptying correlates with contractility. However, since most 'non-contractors' can contract, we suggest the term 'non-emptying' or 'emptying' to describe gallbladder dynamics. The positive correlation between pain and contractility suggests that biliary pain has a muscular component.