Yasui A, Nimura Y, Kamiya J, Hayakawa T, Shibata T, Shionoya S
1st Department of Surgery, Nagoya University School of Medicine, Japan.
Surg Endosc. 1989;3(4):216-9. doi: 10.1007/BF02171549.
Using a percutaneous transhepatic cholangioscopy (PTCS) catheter, sphincter of Oddi motility was measured in a patient with papillary stenosis secondary to bile duct stones. Prior to sphincterotomy, intramuscular injection of 20 micrograms caerulein did not inhibit pathological contraction waves of the sphincter of Oddi or relieve abdominal pain. Endoscopic sphincterotomy of the lower segment of the sphincter of Oddi resulted in recovery of the normal response to caerulein, i.e. relaxation of the sphincter of Oddi. This observation indicates that the pathological contraction and lack of relaxation to cholecystokinin in a patient with papillary stenosis is due to high common bile duct pressure. The measurement of motility of sphincter of Oddi via the PTCS route is useful in diagnosing motor disorders in the sphincter of Oddi and is helpful in deciding to perform endoscopic sphincterotomy.
使用经皮经肝胆道镜检查（PTCS）导管，对一名因胆管结石继发乳头狭窄的患者进行了Oddi括约肌运动功能测量。在括约肌切开术前，肌肉注射20微克雨蛙素并未抑制Oddi括约肌的病理性收缩波，也未缓解腹痛。对Oddi括约肌下段进行内镜括约肌切开术后，对雨蛙素的正常反应得以恢复，即Oddi括约肌松弛。该观察结果表明，乳头狭窄患者中Oddi括约肌的病理性收缩及对胆囊收缩素缺乏松弛反应是由于胆总管压力过高所致。通过PTCS途径测量Oddi括约肌的运动功能，有助于诊断Oddi括约肌的运动障碍，并有助于决定是否进行内镜括约肌切开术。
