INFLUENCE OF CHOLECYSTECTOMY ON SPHINCTER OF ODDI MOTILITY

Background-Gall bladder and sphincter of Oddi (SO) function are coordi nated by hormonal and neuronal mechanisms. Nerve fibres pass between t he gall bladder and the SO via the cystic duct. It is therefore possib le that cholecystectomy may alter SO motility. Aim-To investigate the effect of cholecystectomy on SO function Methods-SO manometry was perf ormed in five women (median age 52 years), a few days before and six m onths after laparoscopic cholecystectomy which was undertaken for unco mplicated cholelithiasis. Basal and post-cholecystokinin (CCK) SO moti lity were measured. Results-All patients were symptom free after lapar oscopic cholecystectomy. Prior to surgery common bile duct pressure, a nd tonic and phasic SO motility were normal and phasic contractions we re inhibited by intravenous CCK (1 Ivy Dog Unit/kg). Six months later, common bile duct pressure and baseline tonic and phasic activity were unchanged but CCK failed to suppress phasic activity. Conclusion-Chol ecystectomy, at least in the short term, suppresses the normal inhibit ory effect of pharmacological doses of CCK on the SO. The mechanism of this effect is unknown but it could be due to SO denervation.