Influence of Electroacupuncture on Acupoints of Yanglingquan (GB34) on Gallbladder Volume and Gallbladder Arterial Hemodynamics in Patients With Chronic Cholecystitis

Introduction: In China, patients with chronic cholecystitis account for approximately 10% of the total population, in which over 90% of cholecystitis is caused by cholelithiasis. This study aimed to discuss the possible mechanism of electroacupuncture on the Yanglingquan acupoint promoting gallbladder contractibility of patients with chronic cholecystitis. Methods: 60 patients were randomly divided into a trial group and a control group. Doppler ultrasound and color Doppler blood flow imaging was applied. The trial group adopted the BT701-1B electroanesthesia apparatus to perform electroacupuncture on the bilateral acupoints of Yanglingquan, while electroacupuncture was made on sham acupoints in the control group. Results: Before the electroacupuncture, gallbladder volume was 49.6 ± 5.66 ml, after 15 min and 30 min of electroacupuncture, the gallbladder volume was then 32.9 ± 5.66 ml and 23.0 ± 2.83 ml respectively. The comparison before and after electroacupuncture was obviously and statistically different (P < 0.01). The comparison between after 15 min and 30 min is obviously statistically different (P < 0.01). Before the electroacupuncture, the gallbladder artery Vmax, Vmin, and RI were 18.4 ± 2.69 cm/s, 9.7 ± 0.07 cm/s, and 0.47 ± 0.06, respectively; the cystic artery Vmax, Vmin, and RI after 30 min were 8.1 ± 0.92 cm/s, 3.1 ± 0.57 cm/s, and 0.61 ± 0.02. The comparison in gallbladder artery Vmax and Vmin and the drag index (RI) before and after electroacupuncture was obviously and statistically different (P < 0.01). Conclusions: Electroacupuncture on the acupoints of Yanglingquan has the potential to promote the emptying of the gallbladder. The mechanism may be related to that the smooth muscle of the gallbladder contracts after electroacupuncture and the gallbladder empties.

Comparison of Ultrasonographic Evaluation of Gallbladder Volume in Type II Diabetic Patients with Non-diabetic Healthy Subjects

Background: Measurement of increased gallbladder volume is necessary for the detection of pathology of gallbladder. Objective: The purpose of the present study was to find out the difference between ultrasonographically measured gall bladder volume in fasting and post prandial states of type II diabetic patients and non-diabetic control subjects. Methodology: This cross-sectional study, carried out department of Radiology and Imaging at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Hospital, Dhaka, Bangladesh from June 2013 to July 2014. The type II diabetic patients were selected as group A and the healthy individual with age and sex matched were selected as group B. An ultrasonographic evaluation of fasting gallbladder volume and 2 hours after meal was done in all the subjects using a 3.5 MHz transducer. Information was recorded in preformed data collection sheet. Results: There was statistically significant (p<0.001) difference of mean fasting gall bladder volume between diabetic and non-diabetic subjects. The mean postprandial gall bladder volume of type II diabetic patients was significantly higher than that of the non-diabetic controls. By using Karl-Pearson coefficients of correlation it was found that gallbladder enlargement in type II diabetics, was significantly correlated with body mass index (p= 0.05) and systolic blood pressure (p= 0.05). Conclusions: Cholecystomegaly is found in type II diabetics in the present study to a significant degree which is also significantly correlated with body mass index and systolic blood pressure. Journal of Current and Advance Medical Research, July 2021;8(2):114-118

Comparative Study Gallbladder Contractility Index Using Ultrasound in Patients with and without Liver Cirrhosis

Liver cirrhosis leads to impairment of gallbladder contractility resulting in bile stasis and facilitate the development of gallstones that will aggravate the clinical symptoms of the patients. The gallbladder contractility index is an indicator of gallbladder motility measured using ultrasound as the radiological choice of modality. This study aims to determine differences in the gallbladder contractility index using ultrasound in patients with and without liver cirrhosis. This study was an observational study of comparative analytic with cross-sectional design with sampling conducted by consecutive admissions sampling at Dr. Hasan Sadikin General Hospital Bandung from December 2017 to February 2018. Statistical analysis than performed by using an independent t test to find out the difference of gallbladder contractility index in patients with and without liver cirrhosis. A total of 22 subjects, 12 men, 10 women, with the youngest 37 years old and the oldest 70 years old. The result of the study was obtained mean fasting gallbladder volume (35.56±22.16 mL) and postprandial (21.25±16.08 mL) in patients with liver cirrhosis higher than without liver cirrhosis with mean fasting gallbladder volume (16.50±4.14 mL) and postprandial (5.44±2.10 mL). The average gallbladder contractility index on patients with liver cirrhosis (41.64±24.52%) smaller than without liver cirrhosis (66.73±9.19%). The result of the statistical test showed that there was a significant difference in the gallbladder contractility index on patients with liver cirrhosis than without liver cirrhosis (p=0.007, p≤0.05). In conclusion, there was a significant difference in the gallbladder contractility index that measured by using ultrasound between the patients with and without liver cirrhosis. PERBEDAAN INDEKS KONTRAKTILITAS KANDUNG EMPEDU MENGGUNAKAN ULTRASONOGRAFI PADA PENDERITA SIROSIS HATI DAN TANPA SIROSIS HATISirosis hati menyebabkan gangguan indeks kontraktilitas kandung empedu yang mengakibatkan stasis cairan empedu dan memudahkan kejadian batu empedu yang akan memperberat gejala klinis pasien. Indeks kontraktilitas kandung empedu merupakan indikator motilitas kandung empedu yang diukur menggunakan ultrasonografi (USG) sebagai modalitas pilihan radiologi. Penelitian ini bertujuan mengetahui perbedaan indeks kontraktilitas kandung empedu menggunakan ultrasonografi pada pasien sirosis hati dan tanpa sirosis. Penelitian ini menggunakan studi observasional analitik komparatif dengan rancangan cross-sectional dan pengambilan sampel dilakukan secara consecutive admissions sampling di RSUP Dr. Hasan Sadikin Bandung dari bulan Desember 2017 hingga Februari 2018. Uji statistik menggunakan independent t test. Subjek penelitian berjumlah 22, laki-laki 12 dan perempuan 10, serta usia termuda 37 tahun dan tertua 70 tahun. Hasil penelitian didapatkan volume rerata kandung empedu puasa (35,56±22,16 mL) dan pascaprandial (21,25±16,08 mL) pada pasien sirosis hati lebih besar daripada tanpa sirosis hati dengan volume rerata kandung empedu puasa (16,50±4,14 mL) dan pascaprandial (5,44±2,10 mL). Indeks kontraktilitas rerata kandung empedu penderita sirosis hati (41,64±24,52%) lebih rendah dibanding dengan tanpa sirosis hati (66,73±9,19%). Hasil uji statistik menunjukkan terdapat perbedaan bermakna antara indeks kontraktilitas kandung empedu penderita sirosis hati dan tanpa sirosis hati (p=0,007; p≤0,05). Simpulan, terdapat perbedaan bermakna antara indeks kontraktilitas kandung empedu menggunakan USG pada penderita sirosis hati dan tanpa sirosis hati.

A Randomized, Double-Blind, Placebo-Controlled Parallel Study Demonstrating the Efficacy of A-F Betafood® on Gallbladder Function (P06-125-19)

Objectives To evaluate the efficacy of A-F Betafood® on gallbladder and liver function in healthy overweight adults. Methods A multi-center, randomized, double-blind, placebo-controlled parallel study was conducted on 50 healthy male and female adults 41–69 years of age, BMI 23.5–32.1 kg/m2 experiencing gastrointestinal distress when consuming fatty foods. Participants were randomized into two interventions: A-F Betafood® or placebo and consumed 2 tablets of the products with a meal, 3 times daily for 12 weeks. At baseline and week 12, liver function tests were performed as well as an ultrasound following a fat rich liquid meal to determine gallbladder volume, wall thickness, ejection fraction and ejection rate. Safety measurements included adverse events, vital signs, anthropometric measures, hematology and clinical chemistry. Results Forty-two subjects completed the study. There was a significant 9% (p = 0.049) decrease in gallbladder wall thickness in participants supplemented with A-F Betafood® while those on placebo showed a 6% increase. Significant within-group reductions of 32% (p = 0.044) in gallbladder volume 30 minutes post-meal and a significant increase of 19% (p = 0.047) in ejection fraction were observed in participants in the A-F Betafood® group but not in the placebo group following the 12-week supplementation. Gallbladder ejection rate showed non-significant 15% increase in participants supplemented with A-F Betafood® while those on placebo showed an 8% decrease. Gallbladder volume, emptying and ejection fraction were not significantly different between A-F Betafood® and placebo. There were no clinically relevant adverse events and safety parameters remained within normal clinical ranges. Conclusions Healthy participants, experiencing gastrointestinal distress when consuming fatty foods, showed clinically relevant improvements in gallbladder motility and gallbladder wall thickness without experiencing any adverse events when supplemented with A-F Betafood® for 12 weeks. Significant within group reductions in gallbladder volume and increases in ejection fraction, and non-significant increases in ejection rate are indicative of improvements in gallbladder motility suggesting a role for A-F Betafood® in populations at risk for gallbladder malfunction. Funding Sources Standard Process Inc., Palmyra, WI.

Sonographic Evaluation of Effect of Smoking and Fatty Meals on Gallbladder

Background: It is well established that fatty food causes gallbladder contraction by releasing cholecystokinin (CCK). Smoking also causes contraction of gallbladder. There are a limited number of studies evaluating the effect of smoking and fatty meals on gallbladder motility by ultrasonography.Objective: The aim of this study is to see the effect of smoking on gallbladder contraction in comparison with fatty meals.Materials and Methods: This cross sectional study was conducted on thirty young adult male volunteers having age between 18−40 years in the department of Radiology and Imaging of Bangabandhu Sheikh Mujib Medical University. Unbiased gallbladder volume measurement of each volunteer was taken on two separate days before and after taking fatty food and as well as before and after smoking at 5,15, 30 and 60 minutes interval. All information were meticulously recorded in structured data collection sheet and analyzed statistically. Then mean gallbladder volume changes against time were presented graphically for two groups using the pre and post smoking values.Results: The result shows that smoking has contractile effect on gallbladder like fatty food. The mean comparison of net change of gallbladder volume before and after smoking and before and after fatty food intake in both smoker and non-smoker groups has been statistically significant (p<0.05).Conclusion: Fatty food and smoking should be strictly prohibited before ultrasonography of hepatobiliary system for better evaluation.J Enam Med Col 2018; 8(1): 29-34