Chandramouli B, Gupta S M, Cohen G E
Division of Nuclear Medicine, Danbury Hospital, CT 06810.
Clin Nucl Med. 1994 Sep;19(9):800-2. doi: 10.1097/00003072-199409000-00012.
Endoscopic sphincterotomy has been used for the treatment of many biliary disorders, including extraction of obstructing common bile duct stones. Manometric studies of the sphincter of Oddi and the common bile duct have shown a marked decrease in biliary tract pressures after sphincterotomy. A prospective study of 12 patients with intact gallbladders using hepatobiliary imaging before and after sphincterotomy was performed to assess changes in bile dynamics. Nonfilling of the gallbladder occurred in 9 of the 12 patients after sphincterotomy, indicating significant alteration of bile flow. Such changes in bile dynamics may have serious implications in patients selected for medical dissolution of gallstones. It may also adversely affect specificity of cholescintigraphy in diagnosing acute cholecystitis.
内镜括约肌切开术已被用于治疗多种胆道疾病，包括取出阻塞性胆总管结石。对Oddi括约肌和胆总管的测压研究表明，括约肌切开术后胆道压力显著降低。对12例胆囊完整的患者进行了前瞻性研究，在括约肌切开术前和术后进行肝胆成像，以评估胆汁动力学的变化。12例患者中有9例在括约肌切开术后胆囊不显影，表明胆汁流动发生了显著改变。胆汁动力学的这种变化可能对选择药物溶解胆结石的患者产生严重影响。它也可能对诊断急性胆囊炎的胆闪烁造影的特异性产生不利影响。
