M. Ugljesic et al., ENDOSCOPIC BILIARY MANOMETRY IN CHOLECYSTECTOMIZED PATIENTS WITH AND WITHOUT CHOLEDOCHOLITHIASIS, Hepato-gastroenterology, 45(21), 1998, pp. 651-655
BACKGROUND/AIMS: Direct study of the function of the sphincter of Oddi
became possible recently with the advent of endoscopic manometry. A d
ysfunction of the bilio-pancreatic sphincter apparatus has been implic
ated in some bilio-pancreatic disorders. The purpose of this study was
to examine the relation between dysfunction of the sphincter of Oddi
and the formation of common bile duct stones. METHODOLOGY: Endoscopic
biliary manometry was performed on 45 cholecystectomized patients. End
oscopic retrograde cholangiography showed choledocholithiasis in 26 pa
tients while 19 patients were free of common bile duct stones. Nine he
althy subjects served as controls. RESULTS: Manometric investigation s
howed a significant increase in the percentage of retrograde phasic co
ntractions of the sphincter of Oddi (SO) in patients with choledocholi
thiasis compared to the control group (p<0.05). Also, a significantly
higher frequency of SO phasic contractions was found in the group of p
atients with choledocholithiasis when compared to the cholecystectomiz
ed group without common bile duct stones (p<0.05), but there was no di
fference when compared with the control group. Markedly increased SO b
asal pressure was found in 5 patients with choledocholithiasis as well
as in one cholecystectomized patient without choledocholithiasis (gre
ater than x+3SD). However, the SO basal pressure, phasic SO pressure,
amplitude and duration of the phasic contractions as well as the chole
dochal pressure did not differ significantly between the groups. CONCL
USIONS: This study demonstrates manometric abnormalities in the SO of
patients with choledocholithiasis which suggests that SO dysfunction a
nd pathophysiological mechanisms are related to the formation of commo
n bile duct stones.