Postprandial gallbladder motility and plasma cholecystokinin at regular time intervals after injection of octreotide in acromegalics on long-term treatment

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Abstract
The increased risk of gallstone formation in acromegalics treated with the somatostatin analog octreotide has been related to an impaired gallbladder emptying. To determine the duration of these inhibitory effects, meal-stimulated gallbladder motility, plasma cholecystokinin (CCK), and pancreatic polypeptide (PP) were measured in five acromegalics treated for 6–32 months with 200–300 μg octreotide daily. Meal tests were performed 45 min, 8 hr and two weeks after the last 100-μg subcutaneous dose. Results were compared with those in normal subjects. Integrated postprandial gallbladder contraction (−125±194 cm3/120 min) and integrated PP secretion (−0.1±0.2 nmol/liter/120 min) were completely suppressed in the 45-min study, but significantly improved (P3/120 min and 3.0±1.0 nmol/liter/120 min) and two weeks (1437±263 cm3/120 min and 10.6±1.6 nmol/liter/120 min) after the last dose of octreotide. The integrated gallbladder contraction in acromegalics at 8 hr was comparable to that at two weeks and to that in normal subjects, but the integrated PP response at 8 hr was significantly smaller (PP<0.05 vs 45 min and 8 hr). In conclusion, during long-term octreotide treatment in acromegalics, initial abolishment of postprandial gallbladder emptying is completely reverted to normal values 8 hr after the last subcutaneous dose. No major differences in postprandial plasma CCK at 45 min and at 8 hr were observed when compared with normal subjects, whereas plasma PP responses were diminished.