Setakis N, Vennart W, Gardner A M, Nayak P
Ann R Coll Surg Engl. 1984 May;66(3):175-8.
A simple peroperative flow test has been developed to help detect organic stenosis of the Ampulla of Vater. The influence of glucagon and propantheline bromide on the flow of saline through the Ampulla during operation in 79 patients was measured. By measuring the flow rate of saline before and after the administration of glucagon to patients the effective diameter of the sphincter of Oddi and its ability to relax could be deduced. Glucagon was found to be most effective in relaxing the Ampulla. For the test to be successful impacted stones must be excluded by cholangiography, but free lying stones do not affect the test. In 7 of the 62 patients receiving glucagon flow was slow and the sphincter failed to relax. Two of these patients had impacted stones and were treated by ampullary dilatation and the other 5 (who had no stones showing on X-rays) were treated by trans-duodenal sphincterotomy; 2 of these patients were found to have small non-obstructing stones impacted at the Ampulla.
已开发出一种简单的术中流量测试，以帮助检测 Vater 壶腹的器质性狭窄。测量了 79 例患者手术期间胰高血糖素和溴丙胺太林对盐水通过壶腹流量的影响。通过测量向患者注射胰高血糖素前后盐水的流速，可以推断出 Oddi 括约肌的有效直径及其松弛能力。发现胰高血糖素在松弛壶腹方面最有效。为使测试成功，必须通过胆管造影排除嵌顿结石，但游离结石不影响测试。在 62 例接受胰高血糖素治疗的患者中，有 7 例流量缓慢，括约肌未能松弛。其中 2 例患者有嵌顿结石，接受了壶腹扩张治疗，另外 5 例（X 光片上未显示结石）接受了经十二指肠括约肌切开术治疗；其中 2 例患者被发现有小的非阻塞性结石嵌顿在壶腹处。
