**2.10 Gallbladder motility**

Defective gallbladder motility is another risk factor for cholesterol stones [78]. About one-third of patients with cholesterol gallstones display enlarged fasting and post prandial residual gallbladder volume with delayed emptying which antedates gallstone formation [79]. Sufficient time for cholesterol nucleation and gallstone growth is provided by dysfunctional gallbladder motility [80]. Various conditions are associated with dysfunctional gallbladder motility like insulin resistance, diabetes, irritable bowel syndrome, liver cirrhosis, and so on [81]. There is increase in lithogenic bile secretion to small intestine directly from liver in fasting motility defect, leading to faster recycling of bile acids and increasing bile acid pool hydrophobicity [82]. This is another predisposing factor for cholesterol crystallization and cholelithiasis [83].
