Continuous measurement of common bile duct pressure with an indwelling microtransducer catheter introduced by duodenoscopy: new diagnostic aid for postcholecystectomy dyskinesia--a preliminary report.

Morphine was given to two patients suspected of having postcholecystectomy dyskinesia to induce spasm of sphincter of Oddi and was successful in reproducing pain, while common bile duct pressure was continuously monitored with an indwelling high fidelity microtransducer catheter introduced by duodenoscopy. The rise of intracholedochal pressure was found to coincide exactly with the occurrence of the pain, thus suggesting the biliary origin of the symptom. The common bile duct pressure started to rise immediately after the injection of morphine, and the pressure waves initially showing biphasic variation of respiratory origin became irregular in shape and height, probably reflecting the spasm of the sphincter; these changes were well related to the intensity of the pain. Endoscopic sphincterotomy gave complete relief. A repeat morphine-induced pressure study after the sphincterotomy confirmed the disappearance of both the pain and the irregular waves.