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Gallbladder function before and after fundoplication.

John M Morton1, Steven P Bowers, Tananchai A Lucktong

  • 1Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7210, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|December 31, 2002
PubMed
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Gastroesophageal reflux disease (GERD) is linked to gallbladder motor dysfunction. Fundoplication surgery improved gallbladder function in most GERD patients, suggesting a potential connection between GERD and gallbladder motility.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Biliary System Physiology

Background:

  • Gastroesophageal reflux disease (GERD) is common, but its impact on gallbladder function is not well-understood.
  • Previous research has not established a link between GERD, its treatments, and gallbladder motility.
  • Fundoplication is a surgical procedure for GERD, involving manipulation of the vagus nerve, which may affect gastrointestinal motility.

Purpose of the Study:

  • To investigate pre- and postoperative gallbladder function in patients with GERD undergoing fundoplication.
  • To determine if chronic GERD is associated with preexisting gallbladder motor dysfunction.
  • To assess the impact of fundoplication and vagotomy on gallbladder motility.

Main Methods:

  • Nineteen patients with GERD underwent preoperative cholecystokinin-stimulated technetium hepatobiliary scans (CCK-HIDA) to measure gallbladder ejection fraction (GBEF).

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  • All patients had laparoscopic Nissen fundoplication.
  • Twelve patients had repeat CCK-HIDA scans one month postoperatively for GBEF comparison.

    • Main Results:

    • 58% of GERD patients exhibited gallbladder dysfunction (GBEF <35%) preoperatively, similar to patients with biliary dyskinesia.
    • Gallbladder function normalized postoperatively in 6 of 7 patients with preoperative dysfunction.
    • No association was found between vagus nerve preservation/division and postoperative gallbladder function.

    Conclusions:

    • A significant proportion of GERD patients have gallbladder motor dysfunction prior to fundoplication.
    • Fundoplication surgery appears to improve gallbladder function in many GERD patients.
    • Further research is needed to explore the relationship between GERD, its treatments, and overall gastrointestinal smooth muscle function.