Coelho J C, Wiederkehr J C
Department of Surgery, Federal University of Parana, Curitiba, Brazil.
Am J Surg. 1996 Jul;172(1):48-51. doi: 10.1016/S0002-9610(97)89549-9.
In recent years, applications of electromyographic, cineradiographic, scintilographic, and endoscopic manometric techniques have improved our knowledge of normal and abnormal motility of Oddi's sphincter. This sphincter coordinates the time and rate of secretion of about 3 liters of bile and pancreatic juice into the duodenum daily.
Oddi's sphincter may be evaluated by endoscopic manometry, ultrasound, dynamic hepatobiliary scintigraphy, and laboratory tests. Endoscopic manometry is the best method for evaluating the function Oddi's sphincter.
The basal pressure of Oddi's sphincter is usually 5 to 15 mm Hg greater than the bile and pancreatic duct pressures. Phasic contractions of 50 to 150 mm Hg in amplitude and 3 to 8 contractions per minute in frequency are superimposed on the basal pressure. A small percentage of patients with gastrointestinal symptoms after cholecystectomy has sphincter of Oddi dysfunction, which may have structural abnormality (papillary stenosis) or functional abnormality (Oddi's sphincter dyskinesia).
Elevated basal pressure ( > 40 mm Hg) is the most important manometric finding of Oddi's sphincter dysfunction. Endoscopic sphincterotomy is the treatment of choice for patients with Oddi's sphincter dysfunction and elevated basal sphincter pressure.
近年来，肌电图、动态放射成像、闪烁成像和内镜测压技术的应用增进了我们对奥迪括约肌正常和异常运动的了解。该括约肌协调每天约3升胆汁和胰液排入十二指肠的时间和速率。
奥迪括约肌可通过内镜测压、超声、动态肝胆闪烁成像及实验室检查进行评估。内镜测压是评估奥迪括约肌功能的最佳方法。
奥迪括约肌的基础压力通常比胆管和胰管压力高5至15毫米汞柱。幅度为50至150毫米汞柱、频率为每分钟3至8次的阶段性收缩叠加在基础压力之上。一小部分胆囊切除术后出现胃肠道症状的患者存在奥迪括约肌功能障碍，可能有结构异常（乳头狭窄）或功能异常（奥迪括约肌运动障碍）。
基础压力升高（>40毫米汞柱）是奥迪括约肌功能障碍最重要的测压表现。内镜括约肌切开术是奥迪括约肌功能障碍且基础括约肌压力升高患者的首选治疗方法。
