Radiomanometry, flow rates, and cholangiography in the evaluation of common bile duct disease

White, Thomas Taylor; Waisman, Hipolito; Hopton, David; Kavlie, H

doi:10.1016/0002-9610(72)90314-5

Cited by 47 publications

(25 citation statements)

References 7 publications

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“…Most manometric studies designed to evaluate the SO in experimental animals have yielded indirect recording of the pressure gradient across the SO segment or resistance to flow rather than direct pressure recordings (17)(18)(19)(20) Although a well-defined terminal HPZ was present in the SO of all animals. HPZ at the proximal SO recorded via CBD and PD pull-throughs were detected in only half the animals and were of low amplitude when present.…”

Section: Myoelectric Activitymentioning

confidence: 99%

“…The periodic interruptions of flow lasted -4-6 s, approximately the duration of the SO pressure waves. This seemingly paradoxical finding, observed also in other species (18,25), has led some workers to conclude that the function of phasic SO contractions is to retard CBD outflow (25)(26)(27). When considered further, however, emptying of fluid from the CBD into the SO segment would not be expected during forceful SO contractions, even though the SO contractions propagate toward the duodenum.…”

Section: Myoelectric Activitymentioning

confidence: 99%

See 1 more Smart Citation

Motor function of the opossum sphincter of Oddi.

Toouli¹,

Dodds²,

Honda³

et al. 1983

J. Clin. Invest.

100

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A B S T R A C T We studied the opossum sphincter of Oddi (SO) because in this species the SO is -3 cm in length and its extraduodenal location permits recording of motor activity with negligible interference from duodenal motor activity. The SO cineradiography, CBD inflow of contrast medium, SO manometry, and SO electromyography indicated that rhythmic peristaltic contractions stripped contrast medium from the SO into the duodenum. During SO systole, CBD emptying was transiently interrupted, whereas SO filling occurred during the diastolic interval between SO peristaltic contractions. SO distention increased the frequency of SO peristalsis. We conclude that (a) the dominant feature of the opossum SO is rhythmic peristaltic contractions that originate in the proximal SO and propagate toward the duodenum; (b) these forceful SO peristaltic contractions are myogenic in origin and serve as a peristaltic pump that actively empties the SO segment; (c) CBD outflow occurs passively during SO diastole, but is interrupted transiently during each SO peristaltic contraction; and (d) a short HPZ with active as well as passive components exists in the distal SO segment and acts as a variable resistor to SO outflow.

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Section: Myoelectric Activitymentioning

confidence: 99%

Section: Myoelectric Activitymentioning

confidence: 99%

Motor function of the opossum sphincter of Oddi.

Toouli¹,

Dodds²,

Honda³

et al. 1983

J. Clin. Invest.

100

View full text Add to dashboard Cite

show abstract

“…It helps us to ensure the cholangiographic evidence of free flow across the treated stenosis more objectively. Similarly manometry has been long used as a pre and post operative tool for assessing the results of biliary surgery, endoscopic sphinterotomy and other biliary conditions [10][11][12][13] . After trying the manometric perfusion test to evaluate the treatment success in our patient group, the results were thoroughly analyzed.…”

Section: The Biliary Manometric Perfusion Test Effective In the Evalumentioning

confidence: 99%

Is the Biliary Manometric Perfusion Test Effective in the Evaluation of Balloon Dilatation Treatment Success of Benign Biliary Strictures?

Thomas¹,

Köcher²,

Černá³

et al. 2009

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…The residual pressure, defined as the resting time by White et al [5], shows the pressure at which stabilization was reached after cessation of perfusion..…”

Section: Methodsmentioning

confidence: 99%

Cholangiomanometry in Dilated Bile Ducts without a Dysfunction of Sphincter of Oddi

et al. 1989

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To elucidate the pathophysiological state of a dilated bile duct without a dysfunction of the sphincter of Oddi, cholangiomanometry has been carried out by the constant perfusion method with a variable perfusion flow involving four increased steps, 1.2, 3.3, 6.6, and 15 ml/min, instead of the single step amount, 1.2 ml/min, of the usual routine procedure. The subjects consisted of 61 patients with benign biliary tract diseases in whom no abnormality was seen in their intraductal pressure curve by the routine constant perfusion method, as well as no residual stones and no passage disturbance in the papillary region. Twenty-nine of these patients showed no dilatation of the bile duct (nondilated group), while the bile duct was dilated in the remaining 32 (dilated group). Differences in these two groups then were compared in terms of their intraductal pressure curve revealed by our four-step perfusion testing. The two groups showed no differences in the baseline pressure, the elevation time (the time that it took to reach the opening pressure of the sphincter after starting perfusion), the perfusion pressure and the residual pressure at any given perfusion rate in pressure curve pattern. However, in the reduction time, the time that it took for the pressure curve to return to the residual pressure after cessation of infusion, while there was no significant difference for both groups at the routine perfusion rate of 1.2 ml/min, at the high perfusion rates of 3.3, 6.6, and 15/min, the dilated group demonstrated a significant delay, which was in proportion to the increased volume of the perfusion. Further, the dilated group also showed a correlation of r = 0.75 between the diameter of the common bile duct and the delay in the reduction time at the high perfusion rates. These findings suggest that a dilated bile duct without a dysfunction of the sphincter of Oddi may develop bile stasis only when the bile secretion is extremely increased, that is 5 times or more of the normal volume, (3,000 ml or more/day). Although it is highly unlikely that such cases will be encountered clinically, it seems safe to say that a dilated bile duct does not necessarily imply a biliary stasis. Therefore, a routine cholangiomanometric study makes it possible to determine whether such a patient requires a sphincteroplasty or an enterobiliary bypass.

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Radiomanometry, flow rates, and cholangiography in the evaluation of common bile duct disease

Cited by 47 publications

References 7 publications

Motor function of the opossum sphincter of Oddi.

Motor function of the opossum sphincter of Oddi.

Is the Biliary Manometric Perfusion Test Effective in the Evaluation of Balloon Dilatation Treatment Success of Benign Biliary Strictures?

Cholangiomanometry in Dilated Bile Ducts without a Dysfunction of Sphincter of Oddi

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