Kalloo A N, Tietjen T G, Pasricha P J
Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, MD 21287-4461, USA.
Gastrointest Endosc. 1996 Dec;44(6):696-9. doi: 10.1016/s0016-5107(96)70054-8.
The endoscopic measurement of sphincter of Oddi pressure is a technically difficult procedure requiring significant expertise. Intrabiliary pressure is technically easy to measure. Furthermore, since it is believed that the pathogenesis of pain in patients with sphincter of Oddi dysfunction is attributable to increased intrabiliary pressure, its measurement may be more clinically relevant than measurement of sphincter of Oddi pressure.
Intrabiliary pressures were blindly measured in 54 patients who had sphincter of Oddi manometry for abdominal pain.
In all patients intrabiliary pressure was significantly higher in patients with sphincter of Oddi dysfunction than those with normal sphincter of Oddi pressure (19.6 +/- 2.2 vs 9.6 +/- 1.2 mm Hg; p < 0.01). These findings were similar when patients were stratified according to presence of intact gallbladder (19.3 +/- 1.6 vs 8.8 +/- 1.4; p < 0.01) and to patients without a gallbladder (20.1 +/- 3.8 vs 12/1 +/- 1.3; p = .034). There was positive correlation between intrabiliary pressure and sphincter of Oddi basal pressure. This correlation was significant both in patients with and without gallbladders.
These data suggest that increased intrabiliary pressure may be a useful surrogate marker of sphincter of Oddi dysfunction.
内镜下测量Oddi括约肌压力是一项技术难度大的操作，需要专业技能。测量胆管内压力在技术上较为容易。此外，由于人们认为Oddi括约肌功能障碍患者疼痛的发病机制归因于胆管内压力升高，因此其测量可能比测量Oddi括约肌压力更具临床相关性。
对54例因腹痛行Oddi括约肌测压的患者进行了胆管内压力的盲法测量。
所有患者中，Oddi括约肌功能障碍患者的胆管内压力显著高于Oddi括约肌压力正常的患者（19.6±2.2对9.6±1.2 mmHg；p<0.01）。根据胆囊是否完整对患者进行分层时，结果相似（19.3±1.6对8.8±1.4；p<0.01），在无胆囊的患者中也是如此（20.1±3.8对12.1±1.3；p = 0.034）。胆管内压力与Oddi括约肌基础压力之间存在正相关。这种相关性在有胆囊和无胆囊的患者中均显著。
这些数据表明胆管内压力升高可能是Oddi括约肌功能障碍的一个有用替代指标。
