We sought to examine how the discontinuation of
octreotide in long-term
octreotide-treated acromegalic patients affects the well-documented side-effect of
cholelithiasis. In 14 acromegalic patients, serum
growth hormone levels,
insulin-like growth factor I levels and percentage of relative gallbladder contractility were measured prior to and after the discontinuation of
octreotide. Compared to pretreatment values, the basal
growth hormone and 5-h
growth hormone profiles were 36% and 24%, and 60% and 56% at the end of 1 and 2 weeks, respectively.
Octreotide was found to be eliminated completely from the serum within 3 days after its withdrawal. In all of six patients who did not develop
gallstones, the percentage relative gallbladder contractility normalized within 1 week. In eight patients who developed
gallstones, four of them had restoration of normal contractility within 2 weeks. Our results show that upon withdrawal of
octreotide, gallbladder contractility returns to normal while
growth hormone suppression persists for a longer period of time. Therefore, discontinuation of
octreotide therapy may allow for the clearance of stagnated bile and hence decrease the incidence of
cholelithiasis in acromegalic patients receiving long-term
therapy.