DOES INTRABILIARY PRESSURE PREDICT BASAL SPHINCTER OF ODDI PRESSURE -A STUDY IN PATIENTS WITH AND WITHOUT GALLBLADDERS

Background: The endoscopic measurement of sphincter of Oddi pressure i s a technically difficult procedure requiring significant expertise. I ntrabiliary pressure is technically easy to measure. Furthermore, sinc e it is believed that the pathogenesis of pain in patients with sphinc ter of Oddi dysfunction is attributable to increased intrabiliary pres sure, its measurement may be more clinically relevant than measurement of sphincter of Oddi pressure. Methods: Intrabiliary pressures were b lindly measured in 54 patients who had sphincter of Oddi manometry for abdominal pain. Results: In all patients intrabiliary pressure was si gnificantly higher in patients with sphincter of Oddi dysfunction than those with normal sphincter of Oddi pressure (19.6 +/- 2.2 vs 9.6 +/- 1.2 mm Hg; p < 0.01). These findings were similar when patients were stratified according to presence of intact gallbladder (19.3 +/- 1.6 v s 8.8 +/- 1.4; p < .001) and to patients without a gallbladder (20.1 /- 3.8 vs 12/1 +/- 1.3; p = .034). There was positive correlation betw een intrabiliary pressure and sphincter of Oddi basal pressure. This c orrelation was significant both in patients with and without gallbladd ers. Conclusions: These data suggest that increased intrabiliary press ure may be a useful surrogate marker of sphincter of Oddi dysfunction.