Biliary manometry in patients with cholelithiasis

Abstract

Objective To explore the relationship between cholelithiasis and the function of sphincter of Oddi （SO）. Methods To identify the existence of calculi, choledochoscopy was performed in patients 6 weeks after exploration of the common bile duct （CBD） and T tube drainage, in which 71 were patients with stones in gall bladder, CBD or intra-hepatic bile duct, and 9 with trauma of pancreas or liver. Biliary manometry was performed after choledochoscopy, and an additional manometry was applied after calculus removal if calculi were detected. The indices measured included SO basal pressure （ SOBP）, amplitude of SO contractions （ SOCA）, frequency of SO contractions （SOF） and CBD pressure （CBDP）. The patients with cholelithiasis were classified into cholecystolithiasis group, choledocholithiasis group, and hepatolithiasis group according to the position of calculi. Patients with trauma were assigned as the control group. Results All variables in 50 patients with choledocholithiasis were similar before and after the procedure. The variables in patients with cholecystolithiasis and choledocholithiasis had no difference from those of the control （ P 〉 0.05）. The SOBP and SOCA of patients in hepatolithiasis group were lower than those of the control group （ P 〈 0. 05）, while no difference in SOF was detected （ P 〉 0. 05 ）. Conclusion The function of SO in patients with hepatolithiasis is abnormal （decrease in SOBP and SOCA）. Biliary manometry cannot be the reliable evidence for the existence of calculi in bile duct. Key words: Biliary calculi; Sphincter of Oddi; Manometry