Common Bile Duct Pressure Research Articles

Effect of hepatic and celiac vagal stimulation on common bile-duct pressure.

Bipolar stimulating electrodes were placed on the hepatic and celiac vagi of 6 dogs. The gallbladder was removed and the cystic duct cannulated with an 8 F infant feeding tube, the external end of which was attached to a specially made metal plug. Experiments were then performed on the dogs both when conscious and fasting. No change in common duct pressure was recorded in response to electrical stimulation of these vagal branches in these dogs, as noted in 209 separate stimulations using various combinations of voltage, frequency and duration. Flow rate did not change as noted with a drop counter during stimulations in 11 experiments.

Effects of Alteration of Biliary Pressure on Bile Composition—A Method for Study: Primate Biliary Physiology V.

A method for inducing, maintaining, and measuring different biliary tract pressures was established in rhesus monkeys. A T-tube was placed in the common bile duct and two limbs were exteriorized. All bile was diverted to the exterior via one limb and common bile duct pressure measured through the other limb by a pressure transducer. Interruption of the enterohepatic circulation was controlled by passing the diverted bile through a “stream splitter” which collected a predetermined percentage of the bile and returned the remainder to the animal via a tube duodenostomy. Pressures from —10 to + 25 cm of saline were induced in the common bile duct and each pressure was maintained within the range of respiratory fluctuation for several hours. For purposes of illustration, preliminary data from 1 animal on the effect of biliary pressure on bile flow and secretion of biliary lipids are presented.

The effect of some spasmolytic drugs on the choledocho-duodenal junction in man.

Common bile duct pressure following intravenous administration of morphine was recorded in patients on the fifth day after cholecystectomy. The effect of intravenous administration of atropine, methylscopolamine, butyl-scopolamine, papaverine, and glyceryl nitrate on the morphine-induced pressure elevation was studied continuously for 30 minutes. No significant effect on the morphiogenic pressure elevation in the common duct was obtained after administration of 0.5 mg of atropine nor after 80 mg of papaverine. Methylscopolamine (10 mg) and glyceryl nitrate (0.5 mg sublingually) resulted in a short-lasting depression of the pressure curve. Butylscopolamine (80 mg) produced a marked and sustained depressing effect on the morphine-induced pressure elevation in the common bile duct. The significance of the results is briefly discussed.

Cinefluorographic and electrophysiologic observation of motility of the choledochoduodenal junction in rabbits

To clarify activity of the choledocho-duodenal junction the present study was made using sixty rabbits. A polyethylene tube with Y-connector to the common bile duct toward the duodenum. The tube was used for two purposes, one measuring the intraductal pressure variation of the terminal common bile duct, the other infusing the contrast medium into the common bile duct for the cinecholangiography. Two electrodes were sewn in the Oddi's muscle and duodenum respectively.Electrical activity of the Oddi's muscle and duodenum, intraductal pressure of the terminal common bile duct and the bile flow were simmultaneously recorded on a 16 mm cine film.The results are summerized as follows:1. The intraductal pressure tracing of the terminal common bile duct was divided in two phases, the one is large pressure waves and the other, slow phases of pressure.2. The large waves appeared always in accordance with the electrical activity of the Oddi's muscle and the slow phases accorded with the electrical activity of the duodenum.3. Bile flow was interrupted at the terminal portion of the common bile duct when the appearance of the large pressure waves, that is, electrical activity of Oddi's muscle was observed.4. Bile flow was poured into the duodenum by the appearance of the slow phaSes or pressure, that is, the electrical activity of the duodenum was observed.From these findings the author concluded that the muscle of Oddi has a sphincteric mechanism and acts independently of the activity of the duodenal wall muscle in rabblt.

Common Bile Duct Pressures

Summary 1.Recordings with a strain gauge manometer have been made of naturally occurring pressures in the common bile ducts of patients with indwelling T tubes during rest and after various stimuli. 2.Pressures in the common bile duct are greatly influenced by changes in intra-abdominal pressure. 3.The various types of pressure waves that occur after ingestion of paregoric or a fatty meal are discussed. The pressure waves recorded were similar to those previously recorded in the duodenum. 4.Differences in resting fasting pressures and in pressure waves in patients with and without pancreatitis were noted. 5.Amyl nitrite reduced common bile duct pressure increased by physiologic or pharmacologic action, but had no effect on the increased common bile duct pressure caused by pancreatitis. 6.Based on this observation a clinical test is suggested. Validity of this test will depend on trial in a large number of patients.