Endoscopic manometry of the sphincter of Oddi in sphincterotomized patients. 1995

M Ugljesić, and M Bulajić, and T Milosavljević, and B Stimec
Clinic for Gastroenterology and Hepatology, Institute for Digestive Diseases, Belgrade, Yugoslavia.

OBJECTIVE Endoscopic sphincterotomy (ES) of the sphincter of Oddi (SO) has been accepted as an effective method in extraction of common bile duct stones in postcholecystectomy patients. The purpose of this study was to examine the completeness of the performed ES and observe the post sphincterotomy pancreatic duct sphincter (PDS) activity using endoscopic manometry. METHODS Activity of the sphincter of Oddi was examined in 15 sphincterotomized patients using endoscopic manometry one to 2.5 years after endoscopic sphincterotomy for choledocholithiasis. RESULTS In eight patients absence of choledochoduodenal gradient, baseline pressure and the sphincter of Oddi phasic activity up to 2.5 years after endoscopic sphincterotomy indicated a complete sphincterotomy. In seven patients with incomplete endoscopic sphincterotomy, manometry exhibited either a lower choledochoduodenal gradient and baseline pressure without phasic activity of the sphincter of Oddi (three patients), a sphincter of Oddi activity without choledochoduodenal gradient (one patient), or a complete restitution of the sphincter of Oddi activity 1 to 2 years after endoscopic sphincterotomy (three patients). In five patients, with complete endoscopic sphincterotomy, measurements of pancreatic sphincter activity showed lower values of the pancreatic ductal pressure and baseline pressure, while the pancreatic sphincter phasic activity was equal to that found in the control group. CONCLUSIONS Endoscopic manometry is method which enables us to test the completeness of endoscopic sphincterotomy and to follow the restitution of the phasic contractile function of the sphincter. Manometric findings reveal pancreatic sphincter in most patients as a separate sphincteric entity, the function of which is reduced but not eliminated by a complete endoscopic sphincterotomy.

UI MeSH Term Description Entries
D008297 Male Males
D008365 Manometry Measurement of the pressure or tension of liquids or gases with a manometer. Tonometry,Manometries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009803 Sphincter of Oddi The sphincter of the hepatopancreatic ampulla within the duodenal papilla. The COMMON BILE DUCT and main pancreatic duct pass through this sphincter. Oddi's Sphincter,Oddi Sphincter,Oddis Sphincter,Sphincter, Oddi's
D010183 Pancreatic Ducts Ducts that collect PANCREATIC JUICE from the PANCREAS and supply it to the DUODENUM. Duct of Santorini,Duct of Wirsung,Duodenal Papilla, Minor,Wirsung's Duct,Accessory Pancreatic Duct,Accessory Pancreatic Duct of Santorini,Main Pancreatic Duct,Santorini's Duct,Accessory Pancreatic Ducts,Duct, Accessory Pancreatic,Duct, Main Pancreatic,Duct, Pancreatic,Duct, Santorini's,Duct, Wirsung's,Ducts, Pancreatic,Main Pancreatic Ducts,Minor Duodenal Papilla,Minor Duodenal Papillas,Pancreatic Duct,Pancreatic Duct, Accessory,Pancreatic Duct, Main,Pancreatic Ducts, Accessory,Papilla, Minor Duodenal,Santorini Duct,Wirsung Duct,Wirsungs Duct
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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