SCINTIGRAPHIC EVALUATION OF BILE DYNAMICS BEFORE AND AFTER ENDOSCOPICSPHINCTEROTOMY

Endoscopic sphincterotomy has been used for the treatment of many bili ary disorders, including extraction of obstructing common bile duct st ones. Manometric studies of the sphincter of Oddi and the common bile duct have shown a marked decrease in biliary tract pressures after sph incterotomy. A prospective study of 12 patients with intact gallbladde rs using hepatobiliary imaging before and after sphincterotomy was per formed to assess changes in bile dynamics. Nonfilling of the gallbladd er occurred in 9 of the 12 patients after sphincterotomy, indicating s ignificant alteration of bile flow. Such changes in bile dynamics may have serious implications in patients selected for medical dissolution of gallstones. It may also adversely affect specificity of cholescint igraphy in diagnosing acute cholecystitis.