Sato H, Kodama T, Takaaki J, Tatsumi Y, Maeda T, Fujita S, Fukui Y, Ogasawara H, Mitsufuji S
Third Department of Internal Medicine, Kyoto Prefectural University of Medicine, Japan.
Gut. 1997 Oct;41(4):541-4. doi: 10.1136/gut.41.4.541.
Endoscopic papillary balloon dilatation (EPBD) has been reported as a safe and effective alternative to endoscopic sphincterotomy in the management of common bile duct (CBD) stones; its effect on papillary function has yet to be elucidated.
To investigate sphincter of Oddi (SO) motility before and after EPBD to determine its effect on SO function.
The papillary function of 10 patients with CBD stones was studied using endoscopic manometry before and one week after EPBD. The manometric studies were repeated one month after EPBD in seven patients.
One week after EPBD, CBD pressure, SO peak pressure, SO basal pressure, and SO frequency decreased significantly. One month after EPBD, however, all parameters increased although the increases in SO basal pressure and CBD pressure were not significant. There was no significant difference in values of any parameter before and one month after EPBD. No serious complications occurred.
These data suggest at least partial recovery of papillary function one month after the procedure. EPBD seems to preserve papillary function in treatment of CBD stones; a longer term follow up study with SO manometry should be performed to clarify the effect of EPBD on SO function.
内镜乳头球囊扩张术(EPBD)已被报道为在胆总管(CBD)结石治疗中替代内镜括约肌切开术的一种安全有效的方法;其对乳头功能的影响尚未阐明。
研究EPBD前后Oddi括约肌(SO)的运动,以确定其对SO功能的影响。
对10例CBD结石患者在EPBD前及EPBD后1周使用内镜测压法研究乳头功能。7例患者在EPBD后1个月重复测压研究。
EPBD后1周,CBD压力、SO峰值压力、SO基础压力和SO频率显著降低。然而,EPBD后1个月,尽管SO基础压力和CBD压力的升高不显著,但所有参数均升高。EPBD前和EPBD后1个月任何参数的值均无显著差异。未发生严重并发症。
这些数据表明术后1个月乳头功能至少部分恢复。EPBD在治疗CBD结石时似乎能保留乳头功能;应进行一项使用SO测压法的长期随访研究以阐明EPBD对SO功能的影响。