Measurement of gallbladder emptying sequentially using a single dose of 99mTc-labeled hepatobiliary agent

The gallbladder emptying response to a single large (20 ng/kg) and four equally divided sequential small (5 ng/kg each) doses of octapeptide of cholecystokinin at 20-min intervals was measured in a paired study in six normal subjects noninvasively and quantitatively by a nongeometric method using a gamma camera, computer, and 99mTc-labeled hepatobiliary agent. The gallbladder mean (+/- SD) ejection fraction after a single large dose (20 ng/kg) of octapeptide of cholecystokinin was 34 +/- 24% and after four sequential small (5 ng/kg each) doses was 42 +/- 14%, 45 +/- 28%, 37 +/- 22%, and 32 +/- 27%, respectively (p greater than 0.05). The results of this study indicate that the first part of the 5 ng/kg sequential octapeptide of cholecystokinin dose is as effective as the single 20-ng/kg dose. The gallbladder emptying requires continued presence of high levels of octapeptide of cholecystokinin in the serum closer to levels that initiate contraction and in the absence of which the gallbladder ceases to empty further despite the fact it has inherent capacity to do so. Each of four equal octapeptide of cholecystokinin doses given sequentially elicits, on the average, an equal degree of emptying response. The method has potential for application in the study of the pharmacological effects of drugs on the biliary dynamics using a single dose of 99mTc-labeled hepatobiliary radiopharmaceutical.