Laugier R
Inserm U 260, Faculté de Médecine, Hôpital Sainte Marguerite, Marseille, France.
Endoscopy. 1994 Feb;26(2):222-7. doi: 10.1055/s-2007-1008947.
Endoscopic manometry of the sphincter of Oddi and the main pancreatic duct (MPD) was performed before and after intravenous injection of secretin (1 CU/kg) in 15 control subjects and 19 patients with chronic pancreatitis. Secretin significantly but transiently enhanced the MPD pressure in the controls, whereas chronic pancreatitis patients had an elevated basal MPD pressure and a manometric pattern of sphincter of Oddi dyskinesia. The secretin-induced MPD pressure was also elevated and more sustained in chronic pancreatitis patients compared to controls. No influence of the etiology or MPD ductal diameter was found, but the duration of the disease correlated significantly to the pressure response to secretin in patients. The pressure enhancement was most impressive in chronic pancreatitis of recent onset (less than four years), whereas it was minimal or normal in later stages of the disease. This dynamic manometric test reliably demonstrates sphincter of Oddi dysfunction and an altered response to secretin. The test could have a role to play in the explanation of progressive MPD dilatation as well as in the early diagnosis of chronic pancreatitis.
对15名对照受试者和19名慢性胰腺炎患者在静脉注射促胰液素（1 CU/kg）前后进行了Oddi括约肌和主胰管（MPD）的内镜测压。促胰液素显著但短暂地提高了对照受试者的MPD压力，而慢性胰腺炎患者的基础MPD压力升高，且存在Oddi括约肌运动障碍的测压模式。与对照相比，慢性胰腺炎患者中促胰液素诱导的MPD压力也升高且更持久。未发现病因或MPD导管直径的影响，但疾病持续时间与患者对促胰液素的压力反应显著相关。压力增强在近期发病（少于四年）的慢性胰腺炎中最为明显，而在疾病后期则最小或正常。这种动态测压试验可靠地显示了Oddi括约肌功能障碍以及对促胰液素反应的改变。该试验在解释MPD进行性扩张以及慢性胰腺炎的早期诊断中可能发挥作用。
