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Effect of gastric distension and duodenal fat infusion on biliary sphincter of oddi motility in healthy volunteers

  • Pancreatic And Biliary Disorders
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Abstract

Although sphincter of Oddi (SO) dysfunction has been implicated in the pathogenesis of postcholecystectomy syndrome and pancreatitis, little is known about normal physiologic stimuli, such as intraduodenal fat on human SO motility. Furthermore, gastric distension that frequently accompanies endoscopic manometry has been shown in animal studies to affect SO motility. We evaluated the effects of intraduodenal fat and gastric distension on SO basal pressure. Asymptomatic volunteers had SO manometry performed while sequentially performing gastric distension and intraduodenal fat perfusion. Five subjects (ages 29.8±4.8 years, range 22–35 years) had a mean basal sphincter of Oddi pressure of 23.4±5 mm Hg (range 17–31 mm Hg). Injection of air into the stomach caused no appreciable change in either intragastric pressure or SO pressure. Intraduodenal fat infusion resulted in a decrease in mean SO basal pressure from 23.4±5.0 to 4.4±4.4 mm Hg (P=0.004). These results demonstrate that gastric distension does not affect SO basal pressure and that intraduodenal fat infusion reduces SO basal pressure.

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References

  1. Steinberg WM: Sphincter of Oddi dysfunction: A clinical controversy. Gastroenterology 95: 409–1415, 1988

    Google Scholar 

  2. Geenen JE, Hogan WJ, Dodds WJ, Toouli J, Venu RP: The efficacy of endoscopic sphincterotomy in postcholecystectomy patients with sphincter of Oddi dysfunction: Results of a 4 year prospective study. N Engl J Med 320:82–87, 1989

    PubMed  Google Scholar 

  3. Okazaki K, Yamamoto Y, Kagiyama S, Tamura S, Sakamoto Y, Morita M, et al: Pressure of papillary sphincter zone and pancreatic main duct in patients with alcoholic and idiopathic chronic pancreatitis. Int J Pancreatol 3:457–468, 1988

    PubMed  Google Scholar 

  4. Toouli J, Roberts-Thomson IC, Dent J, Lee J: Sphincter of Oddi motility disorders in patients with idiopathic recurrent pancreatitis. Br J Surg 11:859–863, 1985

    Google Scholar 

  5. Webb TH, Lillemoe KD, Pitt HA: Gastrosphincter of Oddi reflex. Am J Surg 2:193–198, 1988

    Google Scholar 

  6. Torsoli A: Physiology of the human sphincter of Oddi. Endoscopy 20:166–170, 1988

    PubMed  Google Scholar 

  7. Tanaka M, Ikeda S: Sphincter of Oddi manometry: Comparison of microtransducers and perfusion methods. Endoscopy 20:184–188, 1988

    PubMed  Google Scholar 

  8. Sherman S, Hawes RH, Troiano FP, Lehman GA: Pancreatitis following bile duct sphincter of Oddi manometry: Utility of the aspirating catheter. Gastrointest Endosc 38:347–350, 1991

    Google Scholar 

  9. Albert MB, Steinberg WM, Irani SK: Severe acute pancreatitis complicating sphincter of Oddi manometry. Gastrointest Endosc 34:342–345, 1988

    PubMed  Google Scholar 

  10. Tanaka M, Ikeda S, Nakayama F: Nonoperative measurement of pancreatic and common bile duct pressures with a microtransducer catheter and effects of duodenoscopic sphincterotomy. Dig Dis Sci 26:545–552, 1981

    PubMed  Google Scholar 

  11. Tanaka M, Ikeda S, Nakayama F: Continuous measurement of common bile duct pressure with an indwelling microtransducer catheter introduced by duodenoscopy: A new diagnostic aid for post-cholecystectomy dyskinesia—a preliminary report. Gastrointest Endosc 29:83–88, 1983

    PubMed  Google Scholar 

  12. Staritz M: Pharmacology of the sphincter of Oddi. Endoscopy. 20(suppl 1):171–174, 1988

    PubMed  Google Scholar 

  13. Staritz M, Goeke M, Rambow A, Meyer zum Buschenfelde KH: Investigation of the effect of duodenoscopy on sphincter of Oddi manometry. Endoscopy 3:130–132, 1991

    Google Scholar 

  14. Azpiroz F, Malagelada JR: Gastric tone measured by an electronic barostat in health and postsurgical gastroparesis. Gastroenterology 92:934–943, 1987

    PubMed  Google Scholar 

  15. Lavelle JP, Palmieri T, Schulze-Delrieu K, Shirazi S: Motility disorders of the stomach.In Motility Disorders of the Gastrointestinal Tract. S Anuras (ed). New York, Raven Press, 1992, pp 369–384

    Google Scholar 

  16. Worthley CS, Baker RA, Iannos J, Saccone GTP, Toouli J: Human fasting and postprandial sphincter of Oddi motility. Br J Surg 7:709–714, 1989

    Google Scholar 

  17. Toouli J, Geenen JE, Hogan WJ, Dodds WJ, Arndorfer RC: Sphincter of Oddi activity: A comparison between patients with common bile duct stones and controls. Gastroenterology 82:111–117, 1982

    PubMed  Google Scholar 

  18. Yamamura T, Takahashi T, Kusunoki M, Kantoh M, Seino Y, Utsunomiya J: Gallbladder dynamics and plasma cholecystokinin responses after meals, oral water, or sham feeding in healthy subjects. Am J Med Sci 2:102–107, 1988

    Google Scholar 

  19. Mossner J, Grumann M, Zeeh J, Fischbach W: Influence of various nutrients and their mode of application on plasma cholecystokinin (CCK) bioactivity. Clin Invest 2:125–129, 1992

    Google Scholar 

  20. Summers RW, Johlin FC: The pathophysiology, evaluation and management of motility disorders of the biliary tract. Gastroenterol Clin North Am 2:425–435, 1989

    Google Scholar 

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Authors and Affiliations

  1. From the Section of Therapeutic Endoscopy, Division of Gastroenterology, the Johns Hopkins Hospital, Blalock 945, 21287-4461, Baltimore, Maryland

    Anthony N. Kalloo MD & Pankaj J. Pasricha MD

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  1. Anthony N. Kalloo MD
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  2. Pankaj J. Pasricha MD
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This work was supported in part by a research award from the American Society of Gastrointestinal Endoscopy.

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Kalloo, A.N., Pasricha, P.J. Effect of gastric distension and duodenal fat infusion on biliary sphincter of oddi motility in healthy volunteers. Digest Dis Sci 40, 745–748 (1995). https://doi.org/10.1007/BF02064972

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  • DOI: https://doi.org/10.1007/BF02064972

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