Segmentation of the gallbladder: Effect on bile entry and exit and its clinical relevance in a patient with abdominal pain

BACKGROUND: The effects of folds or septa on gallbladder filling and emptying are not known. METHODS: Gallbladder filling and emptying were measured in seven patients with two chambers (segmental) and compared with 10 subjects with a single chamber (control). Percent bile flow into gallbladder, and percent ejection fraction from the proximal and distal segments, and entire gallbladder were measured with cholecystokinin. RESULTS: Bile entry into gallbladder was similar in both groups. In patients with segmentation, overall emptying was low mostly due to poor emptying of the distal segment. CONCLUSION: Segmentation of the gallbladder does not affect bile entry, but acting as a one-way valve, a fold or septum lowers emptying significantly, mostly from the distal segment.