Effect of gastric distension on sphincter of Oddi motility in humans

Abstract

Background~Aim: Although there are many reports in the literature of clinical syndromes resulting from sphincter of Oddi (SO) dysfunction, little is known about the effects of normal physiologic stimuli on SO function. The present study was designed to evaluate the effect of gastric distension on the SO motility through percutaneous transhepatic manometry. Methods: The motility of SO and small bowel(SB) were measured simultaneously by percutaneous transhepatic manometry using 8-lumen perfusion catheter (Zinetic Medical, 3 orifices for SO manometry: 2mm apart and 5 orifices for SB manometry: 10mm apart) in 6 patients(M:F=3:3, mean age: 67.5 years) with intrahepatic stones after complete stone removal by cholangioscopic lithotripsy. They had no previous hepatobiliary or gastrointestinal operation, papillary stenosis, and periampullary diverticulum. After positioning the catheter via PTBD tract, basal recording was performed. Gastric balloon was performed by ballooned nasogastric tube. The balloon was inflated on the regular contraction phase of SO until the patients felt epigastric discomfort. Result: The mean inflation volume of gastric balloon was 450ml (range: 300-700ml). At baseline manometric study, the basal pressure and amplitude and frequency of phasic contraction wave were 20.8 ± 2.3mmHg, 93.4 + 39.1mmHg, and 3.5 ± 1.3/min, respectively. After inflating the gastric balloon, the frequency of phasic contraction decreased to 0.8 + 1.2/min(p 0.05) and 36.6 ± 50.8mmHg(p>0.05), respectively. Conclusion: Gastric distension does not affect SO basal pressure and amplitude of phasic contraction wave, but decreases the contraction frequency of SO in humans.