Pressure measurements in the biliary and pancreatic duct systems in controls and in patients with gallstones, previous cholecystectomy, or common bile duct stones

Csendes, Attila; Kruse, A; Funch‐Jensen, Peter; Øster, M. J.; Ørnsholt, J.; Amdrup, E

doi:10.1016/0016-5085(79)90158-6

Cited by 170 publications

(66 citation statements)

References 23 publications

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“…From table 3, it is clear that all predictions using s t max are correct except for GBs 11,12,17,18,20,22 and 35, thus out of 37 cases, 30 agree with the clinical observations. For comparison, if we use EF , 35% as the pain threshold, the results are far less positive, with less than half agreeing with clinical data.…”

Section: Resultssupporting

confidence: 81%

“…It was found that the pain threshold varied from 14.7 to 59 mmHg [11]. Csendes et al (1979) illustrated that the pain threshold is in the range 15-60 mmHg [12]. The great variation in the pressure range in these studies suggests that the sensor of the pain in the biliary system may be better associated with other mechanical factors associated with the intraluminal pressure, but not directly to the pressure alone.…”

Section: Introductionmentioning

confidence: 90%

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Correlation of Mechanical Factors and Gallbladder Pain

Luo

Hill

et al. 2007

Computational and Mathematical Methods in Medicine

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Acalculous biliary pain occurs in patients with no gallstones, but is similar to that experienced by patients with gallstones. Surgical removal of the gallbladder (GB) in these patients is only successful in providing relief of symptoms to about half of those operated on, so a reliable pain-prediction model is needed. In this paper, a mechanical model is developed for the human biliary system during the emptying phase, based on a clinical test in which GB volume changes are measured in response to a standard stimulus and a recorded pain profile. The model can describe the bile emptying behaviour, the flow resistance in the biliary ducts, the peak total stress, including the passive and active stresses experienced by the GB during emptying. This model is used to explore the potential link between GB pain and mechanical factors. It is found that the peak total normal stress may be used as an effective pain indicator for GB pain. When this model is applied to clinical data of volume changes due to Cholecystokinin stimulation and pain from 37 patients, it shows a promising success rate of 88.2% in positive pain prediction.

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Section: Resultssupporting

confidence: 81%

Section: Introductionmentioning

confidence: 90%

Correlation of Mechanical Factors and Gallbladder Pain

Luo

Hill

et al. 2007

Computational and Mathematical Methods in Medicine

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“…It must be mentioned, however, that only two of these were investigated in :he pancreatic part of the sphincter of Oddi. Prior investigations in our department of patients with peptic ulcers, however, indicated that the manometric findings in the common bile duct and pancreatic duct were uniform (12).…”

Section: Sphincter Of Oddi Activity In Chronic Pancreatitis Has Beenmentioning

confidence: 96%

Endoscopic Manometry of the Sphincter of Oddi and the Pancreatic and Biliary Ducts in Patients with Chronic Pancreatitis

Vestergaard

Kruse

Rokkjaer

et al. 1994

Scandinavian Journal of Gastroenterology

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Sphincter of Oddi activity and the common bile duct (CBD) and pancreatic duct (PD) pressures were measured by means of endoscopic manometry in 15 patients (11 men and 4 women aged 18-77 (median, 40) years) with various degrees of chronic pancreatitis. Eleven of the 15 patients studied had an abnormal manometric pattern: elevated base-line pressures were seen in 8 patients, elevated duct pressures in 6 patients, abnormal peristalsis in 6 patients, and discoordination in 4 patients. There was no relation between the severity of chronic pancreatitis as shown by endoscopic retrograde pancreatography and the pancreatic function test and the manometric findings. However, a positive correlation between the sphincter of Oddi base-line pressure and the pancreatic duct pressure was found. It is concluded that manometric abnormalities are common findings in patients with chronic pancreatitis. Whether this is primary or secondary to the inflammatory process is still uncertain.

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“…2) [2][3][4][5][6]. It is thought that the pressure changes produce a resistance to flow while at the same time propelling small volumes of either bile or pancreatic juice into the duodenum.…”

Section: Sphincter Of Oddi Functionmentioning

confidence: 99%

Clinical aspects of sphincter of oddi function and dysfunction

Toouli

Craig

1999

Curr Gastroenterol Rep

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The sphincter of Oddi (SO) functions to regulate the flow of bile and pancreatic juices as well as to prevent the reflux of duodenal contents into the pancreatobiliary system. When dysfunction of the sphincter occurs, symptoms develop relating to either the biliary or pancreatic portions of the sphincter. The mechanism of this dysfunction remains speculative. SO manometry remains the "gold standard" to correctly diagnose the disorder and stratify therapy. Division of the sphincter is effective for SO stenosis, but there is no proven therapy for SO dyskinesia.

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Pressure measurements in the biliary and pancreatic duct systems in controls and in patients with gallstones, previous cholecystectomy, or common bile duct stones

Cited by 170 publications

References 23 publications

Correlation of Mechanical Factors and Gallbladder Pain

Correlation of Mechanical Factors and Gallbladder Pain

Endoscopic Manometry of the Sphincter of Oddi and the Pancreatic and Biliary Ducts in Patients with Chronic Pancreatitis

Clinical aspects of sphincter of oddi function and dysfunction

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