ENDOSCOPIC MANOMETRY OF THE SPHINCTER OF ODDI IN PATIENTS WITH LEMMELS-SYNDROME

Endoscopic manometry was performed to evaluate the motor activity of t he sphincter of Oddi (OS) in six patients with Lemmel's syndrome, four of whom had acute cholangitis and two of whom had acute pancreatitis. As controls, 24 patients undergoing cholecystectomy without juxtapapi llary duodenal diverticula (JPD) for cholelithiasis or cholesterol pol yps in the gallbladder were also studied. The OS basal pressure and co ntraction pressure values were 12.4 +/- 5.1 mmHg and 103.4 +/- 24.3 mm Hg, respectively, in the patients with Lemmel's syndrome, and 19.5 +/- 5.1 mmHg and 136.8 +/- 28.2 mmHg, respectively, in the control patien ts. These differences between the groups were statistically significan t; however, the wave frequency was not significantly different between the groups. The mean percentages of antegrade, simultaneous, and retr ograde sequences were 37.5% +/- 11.3%, 19.9% +/- 8.7%, and 43.4% +/- 1 1.7%, respectively, in the patients with Lemmel's syndrome, and 66.5% +/- 11.0%, 20.2% +/- 4.7%, and 14.3% +/- 9.2%, respectively, in the co ntrols, The differences between the groups were significant (P < 0.01) for the antegrade and retrograde sequences. These findings indicate t hat dysfunction of the OS in patients with Lemmel's syndrome could be important in the development of hepatocholangiopancreatic disease caus ed by duodenobiliary and duodenopancreatic reflux.