Pharmacological pressure reduction in the human common bile duct.

The effects of pharmaca on artificially elevated pressures in the common bile duct are reported. The measurements were performed using a catheter for pressure measurements, which was introduced with an endoscope via the papilla of Vater into the common bile duct. For the artificial pressure elevation an x-ray contrast medium was instilled into the common bile duct until the pain threshold was reached. Nitroglycerin most effectively reduced the elevated pressures (to 52.1 +/- 12.4%) of the initial value). A weaker effect was produced by Novalgin (74.7 +/- 15.6%) and Buscopan (69.7 +/- 29.1%). With Euphyllin only a small pressure reduction could be observed (86.1 +/- 15.4%). Pain relief in each patient could only be effected with nitroglycerin. The method used makes it possible to estimate the effects of pharmaca on the artificially elevated pressure of the common bile duct objectively by measuring the pressure reduction, and subjectively by registering the diminution of the pain sensation.