Endoscopic Pancreatic and Biliary Manometry in Pancreatic, Biliary, and Papillary Disease, and After Endoscopic Sphincterotomy and Surgical Sphincteroplasty

Overview

Journal Gut

Specialty Gastroenterology

Date 1984 Nov 1

PMID 6500363

Citations 27

Authors

J A Gregg

D L Carr-Locke

Affiliations

Soon will be listed here.

Abstract

Endoscopic manometry was used to measure pancreatic duct, common bile duct, pancreatic duct sphincter and bile duct sphincter pressures in 43 healthy volunteers and 162 patients with a variety of papillary, pancreatic and biliary disorders. Common bile duct pressure was significantly raised after cholecystectomy, with common bile duct stones and papillary stenosis but pancreatic duct pressure only in papillary stenosis. After endoscopic sphincterotomy mean common bile duct pressure fell from 11.2 to 1.1 mmHg and pancreatic duct pressure from 18.0 to 11.2 mmHg. Distinct pancreatic duct sphincter and bile duct sphincter zones were identified as phasic pressures of 3-12 waves/minute on pull-through from pancreatic duct and common bile duct to duodenum. Pancreatic duct sphincter pressures were higher with common bile duct stones and stenosis whereas bile duct sphincter pressures were higher in pancreatitis and stenosis. Bile duct sphincter activity was present in 60% of patients after surgical sphincteroplasty but 21% of patients after endoscopic sphincterotomy. Endoscopic manometry facilitated the diagnosis of papillary stenosis, has allowed study of papillary pathophysiology and has shown a functional inter-relationship between the two sphincteric zones.

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References

Siegel J . Endoscopic management of choledocholithiasis and papillary stenosis. Surg Gynecol Obstet. 1979; 148(5):747-52. View

Anderson M, HAGSTROM Jr W . A comparison of pancreatic and biliary pressures recorded simultaneously in man. Can J Surg. 1962; 5:461-70. View

GEENEN J, Hogan W, Dodds W, STEWART E, Arndorfer R . Intraluminal pressure recording from the human sphincter of Oddi. Gastroenterology. 1980; 78(2):317-24. View

Yvergneaux J, Bauwens E, Van Outryve L, YVERGNEAUX E . Benign stenosis of the papilla of Vater. Diagnosis of 119 cases with conventional and selective low radiomanometry. Acta Chir Belg. 1977; 76(6):523-32. View

GEENEN J, Hogan W, SHAFFER R, STEWART E, Dodds W, Arndorfer R . Endoscopic electrosurgical papillotomy and manometry in biliary tract disease. JAMA. 1977; 237(19):2075-8. View

Weiss H, Kramann B, Wuttke V, ANACKER H . [Basic pressure in the pancreatic duct and in the bile duct: results from 50 standardized duodenoscopic transpapillary pressure measurements (author's transl)]. Med Klin. 1977; 72(12):519-23. View

Bradley V, Nebel O . Clinical evaluation of sphincter of Oddi manometry. Gastrointest Endosc. 1977; 24(1):27-9. DOI: 10.1016/s0016-5107(77)73433-9. View

SAFRANY L . Endoscopic treatment of biliary tract diseases. Acta Gastroenterol Belg. 1978; 41(11-12):659-66. View

PAULINO F, Cavalcanti A . Biopsy of the ampulla of Vater for demonstration of organic stenosis. Surgery. 1960; 48:698-705. View

10.

Bar-Meir S, GEENEN J, Hogan W, Dodds W, STEWART E, Arndorfer R . Biliary and pancreatic duct pressures measured by ERCP manometry in patients with suspected papillary stenosis. Dig Dis Sci. 1979; 24(3):209-13. DOI: 10.1007/BF01308431. View

11.

Tondelli P, Gyr K, Stalder G, ALLGOWER M . The biliary tract. Part I: Cholecystectomy. Clin Gastroenterol. 1979; 8(2):487-505. View

12.

Anderson M, HAUMAN R, Suriyapa C, Schiller W . Pancreatic enzyme levels in bile of patients with extrahepatic biliary tract disease. Am J Surg. 1979; 137(3):301-6. DOI: 10.1016/0002-9610(79)90055-2. View

13.

Nebel O . Manometric evaluation of the papillar of Vater. Gastrointest Endosc. 1975; 21(3):126-8. DOI: 10.1016/s0016-5107(75)73819-1. View

14.

Nakajima M, Kizu M, Akasaka Y, Kawai K . Five years experience of endoscopic sphincterotomy in Japan: a collective study from 25 centres. Endoscopy. 1979; 11(2):138-41. DOI: 10.1055/s-0028-1098339. View

15.

Wong H, Frey C, Gagic N . Intraoperative common duct pressure and flow measurements. Am J Surg. 1980; 139(5):691-5. DOI: 10.1016/0002-9610(80)90364-5. View

16.

LoGiudice J, GEENEN J, Hogan W, Dodds W . Efficacy of the morphine-prostigmin test for evaluating patients with suspected papillary stenosis. Dig Dis Sci. 1979; 24(6):455-8. DOI: 10.1007/BF01299827. View

17.

HAUMAN R, Gramatica L, Anderson M . Effect of specific pancreatic enzymes on the gallbladder. Surg Forum. 1970; 21:388-9. View

18.

ANACKER H, Weiss H, Kramann B . Endoscopic retrograde pancreaticocholangiography in chronic diseases of the pancreas and in papillary stenoses. Gastrointest Radiol. 1978; 3(3):325-34. DOI: 10.1007/BF01887087. View

19.

Carr-Locke D, Gregg J . Endoscopic manometry of pancreatic and biliary sphincter zones in man. Basal results in healthy volunteers. Dig Dis Sci. 1981; 26(1):7-15. DOI: 10.1007/BF01307970. View

20.

Cattell R, Colcock B . Fibrosis of the sphincter of Oddi. Ann Surg. 1953; 137(6):797-806. PMC: 1802786. DOI: 10.1097/00000658-195306000-00003. View