Rolny P, Funch-Jensen P, Kruse A, Thommesen P
Department of Clinical Physiology, Medical Center Hospital, Orebro, Sweden.
Endoscopy. 1991 May;23(3):111-3. doi: 10.1055/s-2007-1010633.
The sphincter of Oddi (SO) motility before and after an artificial elevation of the common bile duct pressure was studied by means of endoscopic manometry in nine female subjects, seven of whom had undergone previous cholecystectomy. An increase in the hydrostatic common bile duct pressure resulted in total inhibition of the phasic SO contractions in the two patients with gallbladders in situ, as well as in four of the cholecystectomized patients. The results thus indicate that the inhibitory effect of hydrostatic common bile duct pressure on the SO motility previously demonstrated in the cat is also present in man. On the other hand, as the inhibition of the phasic contractions failed to occur in three of the postcholecystectomy patients, the findings also suggest that cholecystectomy may result in altered regulation of SO motility in some patients. This mechanism could then contribute to development of pain in susceptible subjects postcholecystectomy. Finally, the results also showed that pain experienced by some patients upon contrast injection during ERCP bears no relationship to SO motility, but is due to an interindividually variable sensitivity of the bile duct wall to the intraluminal pressure variation.
通过内镜测压法，对9名女性受试者在人工升高胆总管压力前后的Oddi括约肌（SO）运动进行了研究，其中7人此前接受过胆囊切除术。胆总管静水压升高导致2名胆囊未切除患者以及4名胆囊切除患者的SO阶段性收缩完全受到抑制。因此，结果表明，先前在猫身上证实的胆总管静水压对SO运动的抑制作用在人类中也存在。另一方面，由于3名胆囊切除术后患者未出现阶段性收缩抑制，研究结果还表明，胆囊切除术可能导致部分患者SO运动调节改变。这种机制可能会导致易感受试者胆囊切除术后疼痛的发生。最后，结果还显示，一些患者在ERCP期间注射造影剂时所经历的疼痛与SO运动无关，而是由于胆管壁对管腔内压力变化的个体敏感性差异所致。
