Ugljesic M, Bulajic M, Milosavljevic T, Stimec B
Institute for Digestive Diseases, University Clinical Center, Belgrade, Yugoslavia.
Hepatogastroenterology. 1998 May-Jun;45(21):651-5.
BACKGROUND/AIMS: Direct study of the function of the sphincter of Oddi became possible recently with the advent of endoscopic manometry. A dysfunction of the bilio-pancreatic sphincter apparatus has been implicated in some bilio-pancreatic disorders. The purpose of this study was to examine the relation between dysfunction of the sphincter of Oddi and the formation of common bile duct stones.
Endoscopic biliary manometry was performed on 45 cholecystectomized patients. Endoscopic retrograde cholangiography showed choledocholithiasis in 26 patients while 19 patients were free of common bile duct stones. Nine healthy subjects served as controls.
Manometric investigation showed a significant increase in the percentage of retrograde phasic contractions of the sphincter of Oddi (SO) in patients with choledocholithiasis compared to the control group (p < 0.05). Also, a significantly higher frequency of SO phasic contractions was found in the group of patients with choledocholithiasis when compared to the cholecystectomized group without common bile duct stones (p < 0.05), but there was no difference when compared with the control group. Markedly increased SO basal pressure was found in 5 patients with choledocholithiasis as well as in one cholecystectomized patient without choledocholithiasis (greater than x + 3SD). However, the SO basal pressure, phasic SO pressure, amplitude and duration of the phasic contractions as well as the choledochal pressure did not differ significantly between the groups.
This study demonstrates manometric abnormalities in the SO of patients with choledocholithiasis which suggests that SO dysfunction and pathophysiological mechanisms are related to the formation of common bile duct stones.
背景/目的：随着内镜测压技术的出现，最近对Oddi括约肌功能进行直接研究成为可能。胆胰括约肌装置功能障碍与某些胆胰疾病有关。本研究的目的是探讨Oddi括约肌功能障碍与胆总管结石形成之间的关系。
对45例胆囊切除患者进行内镜胆道测压。内镜逆行胆管造影显示26例患者有胆总管结石，19例患者无胆总管结石。9名健康受试者作为对照。
测压研究显示，与对照组相比，胆总管结石患者Oddi括约肌（SO）逆行相收缩百分比显著增加（p < 0.05）。此外，与无胆总管结石的胆囊切除组相比，胆总管结石患者组SO相收缩频率显著更高（p < 0.05），但与对照组相比无差异。5例胆总管结石患者以及1例无胆总管结石的胆囊切除患者的SO基础压力明显升高（大于x + 3SD）。然而，各组之间的SO基础压力、SO相压力、相收缩幅度和持续时间以及胆总管压力无显著差异。
本研究显示胆总管结石患者的SO存在测压异常，这表明SO功能障碍和病理生理机制与胆总管结石的形成有关。
