Pressure measurement in pancreatic duct and biliary duct system in dogs with acute pancreatitis.

We investigated the intraductal pressures of the pancreatico-biliary system in dogs with acute pancreatitis. Intraductal pressures were measured by the method of perfusion manometry. After the perfusion with saline (the common bile duct (CBD: 0.8 ml/min, the pancreatic duct (PD: 0.2 ml/min], two parameters, the residual pressure (RP) and the pressure decay time (DT), were measured before and after the induction of acute pancreatitis. The RP of the PD was elevated after inducing severe pancreatitis. There were statistically significant difference of the RP of the PD between severe and moderate pancreatitis. In addition the DT of the PD was also prolonged in severe pancreatitis. There were significant difference of the DT of the PD between moderate and severe pancreatitis. On the other hand the RP of the CBD was also elevated in severe pancreatitis. There were statistically significant difference of the RP of the CBD between severe and moderate pancreatitis. However there was no significant difference between them concerning the DT of the CBD. The histological examination of periampullary area in severe pancreatitis showed measurable inflammatory changes (papillitis). However there was no such finding in moderate pancreatitis. Our results suggest that pressure measurement in the PD is useful for predicting the severity of acute pancreatitis because the pressure of both the PD and the CBD were elevated in severe pancreatitis but not in moderate pancreatitis and this difference is mainly due to the difference of the influence of pancreatitis to the periampullary region.