The lack of effect of metoclopramide on gallbladder volume and contraction in diabetic cholecystoparesis.

Impaired gallbladder contraction has been previously shown in diabetes mellitus. In this study gallbladder contraction was measured by real-time ultrasonography in 20 subjects (eight healthy controls and 12 diabetics) studied twice on 2 consecutive days, before and after intravenous metoclopramide injection. Contraction was expressed by fasting gallbladder volume and residual gallbladder volume after maximal emptying. Fasting volumes were significantly larger in the diabetics (22.4 +/- 2.1 ml) as compared to the controls (16.15 +/- 1.69 ml) (p less than 0.001). Residual volumes were also significantly larger in the diabetics (12.4 +/- 2.09 ml) as compared to the controls (5.6 +/- 0.58 ml) (p less than 0.001). The rate of gallbladder emptying was significantly (p less than 0.001) slower in the diabetics (0.0326 +/- 0.0056) as compared to the controls (0.0498 +/- 0.0066), but no difference could be shown in the diabetics after administration of metoclopramide (0.0368 +/- 0.0048). No difference was found in the diabetic group before and after injection of 10 mg metoclopramide. The results imply that diabetic cholecystoparesis is not entirely related to autonomic neuropathy since it is not corrected by metoclopramide, a known cholinergic stimulant.