Effect of the artificially elevated common bile duct pressure on the motor activity and function of the papilla of Vater. A study by endoscopic manometry.

In 10 patients without disease of the pancreatico-biliary system, the common bile duct pressure was artificially elevated by endoscopic retrograde feeding with saline under manometric control. The motor activity of the papilla of Vater was recorded by endoscopic manometry using the hydraulic capillary perfusion system according to Arndorfer. Compared to the baseline motility, a mild pressure elevation (from 9.75 +/- 1.8 to 13.5 +/- 0.26 mm Hg) had no effect. After the following strong pressure elevation (to 32 +/- 0.9 mm Hg), however, the papillary residual pressure and the wave duration of the papillary contractions increased significantly (p less than 0.001) from 5.5 +/- 0.5 s and 6.3 +/- 0.16 mm Hg to 10.7 +/- 0.75 s and 8.6 +/- 0.64 mm Hg, whereas the papillary contraction frequency and amplitude were not affected. These data indicate several clinically important speculations.