Filling, postcholecystokinin emptying, and refilling of normal gallbladder: effects of two different doses of CCK on refilling: concise communication.

A study of 18 normal subjects was undertaken to evaluate the rapidity of gallbladder filling with Tc-99m IDA during fast, and the degree of emptying and incidence of refilling after intravenous infusion of either 20 or 40 ng/kg of octapeptide of cholecystokinin (CCK-8). During fast, the frequency of onset of gallbladder filling with Tc-99m IDA at 20, 30, 40, and 42 min was 68%, 84%, 95%, and 100%, respectively. Following CCK-8 infusion, the gallbladder mean ejection period of 11 +/- 4 (s.d.) min and ejection fraction of 40% +/- 23 were similar in subjects given either a 20 ng/kg or a 40 ng/kg dose. The frequency of onset of refilling at 20, 30, 40, and 50 min after CCK-8 was 33%, 63%, 71%, and 79%, respectively for the combined groups. At 50 min after CCK-8, all subjects given 20 ng/kg refilled, whereas only 63% of the 40-ng/kg group did so. There was no correlation between the degree of emptying (ejection fraction) and onset of refilling. We conclude that the frequency of post CCK-8 onset of gallbladder refilling, which reflects sphincter tone recovery, is widely variable, depending upon both the dose and the duration from the time of infusion of CCK-8 and should be taken into consideration if a pre-emptying procedure is adopted during hepatobiliary imaging with Tc-99m IDA agents.