Tomita R, Tanjoh K
First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
Surg Today. 1998;28(3):258-61. doi: 10.1007/s005950050117.
Endoscopic manometry was performed to evaluate the motor activity of the sphincter of Oddi (OS) in six patients with Lemmel's syndrome, four of whom had acute cholangitis and two of whom had acute pancreatitis. As controls, 24 patients undergoing cholecystectomy without juxtapapillary duodenal diverticula (JPD) for cholelithiasis or cholesterol polyps in the gallbladder were also studied. The OS basal pressure and contraction pressure values were 12.4 +/- 5.1 mmHg and 103.4 +/- 24.3 mmHg, respectively, in the patients with Lemmel's syndrome, and 19.5 +/- 5.1 mmHg and 136.8 +/- 28.2 mmHg, respectively, in the control patients. These differences between the groups were statistically significant; however, the wave frequency was not significantly different between the groups. The mean percentages of antegrade, simultaneous, and retrograde sequences were 37.5% +/- 11.3%, 19.9% +/- 8.7%, and 43.4% +/- 11.7%, respectively, in the patients with Lemmel's syndrome, and 66.5% +/- 11.0%, 20.2% +/- 4.7%, and 14.3% +/- 9.2%, respectively, in the controls. The differences between the groups were significant (P < 0.01) for the antegrade and retrograde sequences. These findings indicate that dysfunction of the OS in patients with Lemmel's syndrome could be important in the development of hepatocholangiopancreatic disease caused by duodenobiliary and duodenopancreatic reflux.
对6例莱姆尔综合征患者进行了内镜测压，以评估Oddi括约肌（OS）的运动活性，其中4例患有急性胆管炎，2例患有急性胰腺炎。作为对照，还研究了24例因胆结石或胆囊胆固醇息肉而接受胆囊切除术且无乳头旁十二指肠憩室（JPD）的患者。莱姆尔综合征患者的OS基础压力和收缩压力值分别为12.4±5.1 mmHg和103.4±24.3 mmHg，对照患者分别为19.5±5.1 mmHg和136.8±28.2 mmHg。两组之间的这些差异具有统计学意义；然而，两组之间的波频率没有显著差异。莱姆尔综合征患者顺行、同步和逆行序列的平均百分比分别为37.5%±11.3%、19.9%±8.7%和43.4%±11.7%，对照组分别为66.5%±11.0%、20.2%±4.7%和14.3%±9.2%。两组之间顺行和逆行序列的差异具有显著性（P<0.01）。这些发现表明，莱姆尔综合征患者的OS功能障碍在十二指肠胆管和十二指肠胰腺反流引起的肝胰胆管疾病的发生中可能起重要作用。
