CHOLEDOCHOLITHIASIS, PRESSURES IN THE COM MON BILE-DUCT (WITHOUT AND WITH PARTIAL AND LONG SPHINCTEROTOMY)

In 72 patients operated on for lithiasis of the main biliary duct (MBD ), the intraductal pressure was measured through the choledochostomy T -tube. This measure was done, both in upright and lying positions, fas ting and after lunch. Two groups were considered: A (of 52 cases) and B (of 20 cases). In both groups a choledochotomy was performed, and on ly in group B a long, although partial, sphincterotomy was also done. Three patients in group B had the upper part of the sphincter of Oddi (SO) dilated by big stones. 1) When groups A and B were compared, no s ignificant diferences of pressures in MBD was found. 2) Highly signifi cant diferences (p = 0.0001) were always found when paired data relate d to positions were compared: in the upright position pressures in MBD were higher than on the lying position. Group A, during fasting (9.90 +/- 4.1 cm H2O, in upright position, and 7.76 +/- 3.6 when lying) and group B, also at fasting (8.95 +/- 3.0 in the upright position and 6. 57 +/- 3.0, when lying). The three patients included in group B with b ig stones impacted in the upper part of SO, showed low pressures in MB D, specially one (2 and 1 cm H2O, upright lying positions), but the gr oup is too small have statistical significance. We conclude that the l ong but partial sphincterotomy does not modify significantly the press ures in MBD whether upright or lying, and when paired data related to positions were compared, upright pressures were always higher than on the lying position (p = 0.0001).