Assessment of Gall Bladder Dynamics, Cholecystokinin Release and the Development of Gallstones During Octreotide Therapy for Acromegaly
Abstract
The development of gallstones is a well recognized complication of therapy with the long-acting somatostatin analogue, octreotide in patients with acromegaly. A group of nine acromegalic patients was treated with octreotide at doses of 300-600 micrograms daily for 8 months and the changes in fasting and post-prandial cholecystokinin release, and gall bladder motor function (determined by a radiosotopic technique) were assessed at regular intervals. In addition the development of any gallstones was determined by serial ultrasonography. Fasting cholecystokinin levels showed no significant change over 6 months, whereas the post-prandial levels demonstrated a significant decrease (p less than 0.01) during therapy, yet remained significantly higher than fasting levels. Twenty-four hours after commencing therapy gall bladder ejection fraction was decreased by 57 +/- 23 per cent and gall bladder ejection rate decreased by 63 +/- 19 per cent compared to the pretreatment values, whereas after 6 months' therapy a marked reduction in gall bladder ejection fraction (greater than 35 per cent) and gall bladder ejection rate (greater than 40 per cent) persisted in only four of nine patients. Three of these four patients with persistently impaired gall bladder motor function were subsequently shown to have developed either gallstones or biliary sludge during the course of therapy. We conclude that treatment with octreotide is associated with an impaired post-prandial release of cholecystokin…
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- Authors
- EWINS, D., JAVAID, A., COSKERAN, P., SHAN, S., BUTLER, J., DEPREZ, P., MIELL, J., CALAM, J., BARRETT, J., DAWSON, J., & McGREGOR, A.
- Affiliations
- King's College London (GB)
- Hammersmith Hospital (GB)
- Venue
- QJM: An International Journal of Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 1992-04-01
- Volume
- 83
- Issue
- 1
- Pages
- 295-306
- ISSN
- 0033-5622 (ISSN-L)
- 1460-2393
- 1460-2725
- OpenAlex
- W4300678775
- Cited by
- 25
- References
- 0
- Citations by year
- 2024: 1 · 2023: 1 · 2019: 1 · 2017: 1 · 2016: 2 · 2015: 1 · 2012: 2
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- QJM (publishedVersion)
- PubMed (publishedVersion)
- PubMed
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- acromegaly, octreotide, gallstones, cholecystokinin, gallbladder motility, gallbladder ejection fraction, biliary sludge, somatostatin analogue therapy
- MeSH terms
- Acromegaly, Adult, Aged, Cholecystokinin, Cholelithiasis, Female, Gallbladder, Humans, Male, Middle Aged, Motor Neurons, Pituitary Neoplasms, Prospective Studies, Growth Hormone, Octreotide
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