Skip to main content
PMC home page
Gut logoLink to Gut
. 1993 Feb;34(2):270–273. doi: 10.1136/gut.34.2.270

Effect of octreotide on gall stone prevalence and gall bladder motility in acromegaly.

S M Catnach 1, J V Anderson 1, P D Fairclough 1, R C Trembath 1, P A Wilson 1, E Parker 1, G M Besser 1, J A Wass 1
PMCID: PMC1373983  PMID: 8432484

Abstract

Octreotide therapy in acromegaly is associated with an increased prevalence of gall stones, which may be the result of an inhibition of gall bladder motility. Gall stone prevalence in untreated acromegalic patients relative to the general population is unknown, however, and the presence of gall stones and gall bladder motility in these patients and in acromegalic patients receiving octreotide was therefore examined. Thirty four percent of 39 patients who had taken octreotide for a mean of 20 months had gall stones compared with 16% of 38 patients who had not been treated with octreotide (p < 0.005). In a subgroup of 21 patients studied prospectively over 4 to 18 months, two patients developed stones. No patient had symptoms referrable to their gall stones. In 31 untreated acromegalic patients, the mean fasting gall bladder volume was similar to that in normal subjects. Maximal percentage emptying, however, was impaired (34 v 64%, p < 0.001) and the mean postprandial residual gall bladder volume increased (21.7 v 9.0 ml, p < 0.001). Treatment with octreotide increased the mean postprandial residual volume further to 36.8 ml (p < 0.001). Gall bladder emptying in untreated acromegalic subjects is impaired. Octreotide further increases postprandial residual gall bladder volume and this may be a factor in the increased gall stone prevalence seen in these patients.

Full text

PDF
270

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahrendt S. A., McGuire G. E., Pitt H. A., Lillemoe K. D. Why does somatostatin cause gallstones? Am J Surg. 1991 Jan;161(1):177–183. doi: 10.1016/0002-9610(91)90381-m. [DOI] [PubMed] [Google Scholar]
  2. Barbara L., Sama C., Morselli Labate A. M., Taroni F., Rusticali A. G., Festi D., Sapio C., Roda E., Banterle C., Puci A. A population study on the prevalence of gallstone disease: the Sirmione Study. Hepatology. 1987 Sep-Oct;7(5):913–917. doi: 10.1002/hep.1840070520. [DOI] [PubMed] [Google Scholar]
  3. Besser G. M., Mortimer C. H., Carr D., Schally A. V., Coy D. H., Evered D., Kastin A. J., Tunbridge W. M., Thorner M. O., Hall R. Growth hormone release inhibiting hormone in acromegaly. Br Med J. 1974 Mar 2;1(5904):352–355. doi: 10.1136/bmj.1.5904.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dodds W. J., Groh W. J., Darweesh R. M., Lawson T. L., Kishk S. M., Kern M. K. Sonographic measurement of gallbladder volume. AJR Am J Roentgenol. 1985 Nov;145(5):1009–1011. doi: 10.2214/ajr.145.5.1009. [DOI] [PubMed] [Google Scholar]
  5. Everson G. T., Braverman D. Z., Johnson M. L., Kern F., Jr A critical evaluation of real-time ultrasonography for the study of gallbladder volume and contraction. Gastroenterology. 1980 Jul;79(1):40–46. [PubMed] [Google Scholar]
  6. Everson G. T., McKinley C., Lawson M., Johnson M., Kern F., Jr Gallbladder function in the human female: effect of the ovulatory cycle, pregnancy, and contraceptive steroids. Gastroenterology. 1982 Apr;82(4):711–719. [PubMed] [Google Scholar]
  7. Fisher R. S., Rock E., Levin G., Malmud L. Effects of somatostatin on gallbladder emptying. Gastroenterology. 1987 Apr;92(4):885–890. doi: 10.1016/0016-5085(87)90961-9. [DOI] [PubMed] [Google Scholar]
  8. Fisher R. S., Stelzer F., Rock E., Malmud L. S. Abnormal gallbladder emptying in patients with gallstones. Dig Dis Sci. 1982 Nov;27(11):1019–1024. doi: 10.1007/BF01391749. [DOI] [PubMed] [Google Scholar]
  9. Forgacs I. C., Maisey M. N., Murphy G. M., Dowling R. H. Influence of gallstones and ursodeoxycholic acid therapy on gallbladder emptying. Gastroenterology. 1984 Aug;87(2):299–307. [PubMed] [Google Scholar]
  10. Guillemin R. Somatostatin inhibits the release of acetylcholine induced electrically in the myenteric plexus. Endocrinology. 1976 Dec;99(6):1653–1654. doi: 10.1210/endo-99-6-1653. [DOI] [PubMed] [Google Scholar]
  11. Gullo L., Bolondi L., Scarpignato C., Priori P., Casanova P., Labò G. Effect of somatostatin and thyrotropin-releasing hormone on cholecystokinin-induced gallbladder emptying. Dig Dis Sci. 1986 Dec;31(12):1345–1350. doi: 10.1007/BF01299813. [DOI] [PubMed] [Google Scholar]
  12. Hanks J. B., Kortz W. J., Andersen D. K., Jones R. S. Somatostatin suppression of canine fasting bile secretion. Gastroenterology. 1983 Jan;84(1):130–137. [PubMed] [Google Scholar]
  13. Heaton K. W., Braddon F. E., Mountford R. A., Hughes A. O., Emmett P. M. Symptomatic and silent gall stones in the community. Gut. 1991 Mar;32(3):316–320. doi: 10.1136/gut.32.3.316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Krejs G. J., Orci L., Conlon J. M., Ravazzola M., Davis G. R., Raskin P., Collins S. M., McCarthy D. M., Baetens D., Rubenstein A. Somatostatinoma syndrome. Biochemical, morphologic and clinical features. N Engl J Med. 1979 Aug 9;301(6):285–292. doi: 10.1056/NEJM197908093010601. [DOI] [PubMed] [Google Scholar]
  15. Lamberts S. W. The role of somatostatin in the regulation of anterior pituitary hormone secretion and the use of its analogs in the treatment of human pituitary tumors. Endocr Rev. 1988 Nov;9(4):417–436. doi: 10.1210/edrv-9-4-417. [DOI] [PubMed] [Google Scholar]
  16. Lamberts S. W., Uitterlinden P., Verschoor L., van Dongen K. J., del Pozo E. Long-term treatment of acromegaly with the somatostatin analogue SMS 201-995. N Engl J Med. 1985 Dec 19;313(25):1576–1580. doi: 10.1056/NEJM198512193132504. [DOI] [PubMed] [Google Scholar]
  17. Magnusson I., Einarsson K., Angelin B., Nyberg B., Bergström K., Thulin L. Effects of somatostatin on hepatic bile formation. Gastroenterology. 1989 Jan;96(1):206–212. doi: 10.1016/0016-5085(89)90782-8. [DOI] [PubMed] [Google Scholar]
  18. McKnight J. A., McCance D. R., Sheridan B., McIlrath E., Hadden D. R., Kennedy L., Atkinson A. B. A long-term dose-response study of somatostatin analogue (SMS 201-995, octreotide) in resistant acromegaly. Clin Endocrinol (Oxf) 1991 Feb;34(2):119–125. doi: 10.1111/j.1365-2265.1991.tb00281.x. [DOI] [PubMed] [Google Scholar]
  19. Page M. D., Millward M. E., Taylor A., Preece M., Hourihan M., Hall R., Scanlon M. F. Long-term treatment of acromegaly with a long-acting analogue of somatostatin, octreotide. Q J Med. 1990 Feb;74(274):189–201. [PubMed] [Google Scholar]
  20. Plöckinger U., Dienemann D., Quabbe H. J. Gastrointestinal side-effects of octreotide during long-term treatment of acromegaly. J Clin Endocrinol Metab. 1990 Dec;71(6):1658–1662. doi: 10.1210/jcem-71-6-1658. [DOI] [PubMed] [Google Scholar]
  21. Pomeranz I. S., Shaffer E. A. Abnormal gallbladder emptying in a subgroup of patients with gallstones. Gastroenterology. 1985 Mar;88(3):787–791. doi: 10.1016/0016-5085(85)90152-0. [DOI] [PubMed] [Google Scholar]
  22. Reichlin S. Somatostatin. N Engl J Med. 1983 Dec 15;309(24):1495–1501. doi: 10.1056/NEJM198312153092406. [DOI] [PubMed] [Google Scholar]
  23. René E., Danzinger R. G., Hofmann A. F., Nakagaki M. Pharmacologic effect of somatostatin on bile formation in the dog. Enhanced ductular reabsorption as the major mechanism of anticholeresis. Gastroenterology. 1983 Jan;84(1):120–129. [PubMed] [Google Scholar]
  24. Sassolas G., Harris A. G., James-Deidier A. Long term effect of incremental doses of the somatostatin analog SMS 201-995 in 58 acromegalic patients. French SMS 201-995 approximately equal to Acromegaly Study Group. J Clin Endocrinol Metab. 1990 Aug;71(2):391–397. doi: 10.1210/jcem-71-2-391. [DOI] [PubMed] [Google Scholar]
  25. Schlegel W., Raptis S., Harvey R. F., Oliver J. M., Pfeiffer E. F. Inhibition of cholecystokinin-pancreozymin release by somatostatin. Lancet. 1977 Jul 23;2(8030):166–168. doi: 10.1016/s0140-6736(77)90182-9. [DOI] [PubMed] [Google Scholar]
  26. Tauber J. P., Babin T., Tauber M. T., Vigoni F., Bonafe A., Ducasse M., Harris A. G., Bayard F. Long term effects of continuous subcutaneous infusion of the somatostatin analog octreotide in the treatment of acromegaly. J Clin Endocrinol Metab. 1989 May;68(5):917–924. doi: 10.1210/jcem-68-5-917. [DOI] [PubMed] [Google Scholar]
  27. Zhu X. F., Shi Y. F., Qin-Dai, Zhang J. X., Harris A. G. Effect of small doses of somatostatin analog, octreotide, on gallbladder contractility in normal Chinese adults. Dig Dis Sci. 1992 Jan;37(1):105–108. doi: 10.1007/BF01308351. [DOI] [PubMed] [Google Scholar]
  28. van Liessum P. A., Hopman W. P., Pieters G. F., Jansen J. B., Smals A. G., Rosenbusch G., Kloppenborg P. W., Lamers C. B. Postprandial gallbladder motility during long term treatment with the long-acting somatostatin analog SMS 201-995 in acromegaly. J Clin Endocrinol Metab. 1989 Sep;69(3):557–562. doi: 10.1210/jcem-69-3-557. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES