DOES ENDOSCOPIC SPHINCTEROTOMY DESTROY THE FUNCTION OF ODDIS SPHINCTER

Objective: To evaluate the possible destruction of Oddi's sphincter en doscopic sphincterotomy (ES). Design: Prospective, nonrandomized contr ol trial. The study was done from the beginning of 1986 to the end of 1991. Setting: The Department of Surgery, Salzburg (Austria General Ho spital. Patients: Ninety-one patients with cholecystolithiasis and con comitant different diseases of the common bile duct. Ninety-five patie nts exclusively having cholecystolithiasis served as the control group . Interventions: Patients with cholecystolithiasis plus concomitant di fferent diseases of the common bile duct underwent preoperative ES and , at a second intervention, conventional cholecystectomy. Patients wit h cholecystolithiasis only underwent elective conventional cholecystec tomy. Main Outcome Measures: During the cholecystectomy, three pressur e and flow variables were routinely measured in the common bile duct: the natural resting pressure, the maximum pressure after the standardi zed injection of physiologic saline solution, and the normalizing time (the time required for the reappearance of the initial resting pressu re). Results: The statistical comparison of the two groups showed no s ignificant deviations regarding the resting pressure (P<.4), whereas t he maximum pressure was significantly lower (P<.01) in the group that underwent ES. The normalizing time of patients who underwent ES was no t statistically different (P<.375) from that of the control group pati ents. Conclusion: The function of Oddi's sphincter is changed but not destroyed following ES.