Lee S K, Kim M H, Seo D W, Yoo B M, Lee M H, Myung S J, Min Y I
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Am J Gastroenterol. 1996 Nov;91(11):2395-8.
The sphincter of Oddi (SO) manometry via the transpapillary route is performed usually for a period of several minutes. To investigate whether there is a considerable variation in the manometric measurements of SO over a longer period of time, we have performed long-term manometry of SO via the transpapillary (n = 5) as well as the percutaneous (n = 7) routes.
Transpapillary manometry of SO was carried out by a conventional low-compliant continuously perfused technique. The location of the manometric catheter was maintained at the same level by observing the video monitor. SO manometry and the duodenal migrating motor complex (MMC) was simultaneously measured with a specially designed catheter via the percutaneous route.
The mean recording time was 41 min (range 11-72 min). The frequency of phasic contractions of SO varied from 0 to 12/min. Throughout the entire recording period, high-frequency contractions (over 8/min) were noted 14.9% of the time. In the cases of percutaneous transductal SO manometry, the periods of high-frequency contractions coincided with phase III of duodenal MMC. The interval between the first high-frequency contractions and the second was 47 min. The mean duration of high-frequency contractions was 6 min and 42 s. There was no significant change in the amplitude, basal pressure, and contraction sequence among the various periods of frequencies.
Long-term continuous recording of SO manometry via the transpapillary and percutaneous routes showed that the contraction frequency of SO was not constant and tachyoddia appeared periodically. In the interpretation of tachyoddia, it is necessary to consider the period of phase III of the duodenal MMC.
经乳头途径进行的Oddi括约肌(SO)测压通常持续数分钟。为了研究在更长时间段内SO测压测量值是否存在显著差异,我们通过经乳头途径(n = 5)以及经皮途径(n = 7)对SO进行了长期测压。
通过传统的低顺应性连续灌注技术进行经乳头SO测压。通过观察视频监视器将测压导管的位置保持在同一水平。通过经皮途径使用专门设计的导管同时测量SO测压和十二指肠移行性运动复合波(MMC)。
平均记录时间为41分钟(范围11 - 72分钟)。SO的相性收缩频率在0至12次/分钟之间变化。在整个记录期间,高频收缩(超过8次/分钟)出现的时间占14.9%。在经皮经导管SO测压的病例中,高频收缩期与十二指肠MMC的Ⅲ期一致。第一次高频收缩与第二次之间的间隔为47分钟。高频收缩的平均持续时间为6分42秒。不同频率时期之间的幅度、基础压力和收缩序列没有显著变化。
通过经乳头和经皮途径对SO测压进行长期连续记录表明,SO的收缩频率并非恒定不变,心动过速会周期性出现。在解释心动过速时,有必要考虑十二指肠MMC的Ⅲ期。