Background/Aims: Endoscopic sphincterotomy (ES) of the sphincter of Od
di (SO) has been accepted as an effective method in extraction of comm
on bile duct stones in postcholecystectomy patients. The purpose of th
is study was to examine the completeness of the performed ES and obser
ve the post sphincterotomy pancreatic duct sphincter (PDS) activity us
ing endoscopic manometry. Materials and Methods: Activity of the sphin
cter of Oddi was examined in 15 sphincterotomized patients using endos
copic manometry one to 2.5 years after endoscopic sphincterotomy for c
holedocholithiasis. Results: In eight patients absence of choledochodu
odenal gradient, baseline pressure and the sphincter of Oddi phasic ac
tivity up to 2,5 years after endoscopic sphincterotomy indicated a com
plete sphincterotomy. In seven patients with incomplete endoscopic sph
incterotomy, manometry exhibited either a lower choledochoduodenal gra
dient and baseline pressure without phasic activity of the sphincter o
f Oddi (three patients), a sphincter of Oddi activity without choledoc
hoduodenal gradient (one patient), or a complete restitution of the sp
hincter of Oddi activity 1 to 2 years after endoscopic sphincterotomy
(three patients). In five patients, with complete endoscopic sphincter
otomy, measurements of pancreatic sphincter activity showed lower valu
es of the pancreatic ductal pressure and baseline pressure, while the
pancreatic sphincter phasic activity was equal to that found in the co
ntrol group. Conclusions: Endoscopic manometry is method which enables
us to test the completeness of endoscopic sphincterotomy and to follo
w 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.