Beschreibung:
<jats:title>Abstract</jats:title><jats:p><jats:bold>Background and Aim:</jats:bold> Biliary cholesterol supersaturation, gallbladder stasis and delayed intestinal transit are the key events in cholesterol gallstone formation. We studied the effect of cisapride, a prokinetic drug, on gallbladder emptying and bile composition in patients with gallstone disease undergoing cholecystectomy.</jats:p><jats:p><jats:bold>Methods:</jats:bold> Gallbladder emptying, cholesterol saturation index (CSI) and nucleation time were studied in 21 patients with gallstone disease. Eleven patients (cisapride group, age 41.9 ± 2.9 years) received tablet cisapride 10 mg t.i.d. for 2 weeks, while 10 patients (placebo group, age 42.1 ± 1.9 years) received placebo for the same duration. Gallbladder emptying was repeated in all patients after a 2‐week treatment with cisapride or placebo. Gallbladder bile was obtained at the time of surgery for the measurement of CSI and nucleation time.</jats:p><jats:p><jats:bold>Results:</jats:bold> Residual volume of the gallbladder decreased (mean ± SE, 18.6 ± 2.5 mL <jats:italic>vs</jats:italic> 10.0 ± 1.1 mL, <jats:italic>P</jats:italic> = 0.007), and the ejection fraction increased (43.5 ± 5.3%<jats:italic>vs</jats:italic> 60.0 ± 3.2%, <jats:italic>P</jats:italic> = 0.007) in patients in the cisapride group, while no change was observed in placebo group patients. Nucleation time was higher in the cisapride group than in the placebo group (14.9 ± 1.3 days <jats:italic>vs</jats:italic> 8.0 ± 0.9 days, <jats:italic>P</jats:italic> = 0.003). Patients in the cisapride group had a significantly lower cholesterol concentration (molar percentage, 5.1 ± 0.3%<jats:italic>vs</jats:italic> 6.8 ± 0.8%, <jats:italic>P</jats:italic> = 0.049) and CSI (1.0 ± 0.1 <jats:italic>vs</jats:italic> 1.36 ± 0.11, <jats:italic>P</jats:italic> = 0.034) than patients in the placebo group.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> Cisapride improves gallbladder emptying and bile lithogenicity in patients with gallstone disease.</jats:p>