A study of bile duct dynamics using computer-assisted99mTc-HIDA scintigraphy
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Using computer-assisted scintillation camera imaging bile duct dynamics was studied in 28 patients with a nonvisualizing gallbladder due to acute cholecystitis. Postoperative repeatstudies were carried out in 8 of the 28 patients. In half of the studies three accumulations of activity were evident on the 60 added 1-min views. These three accumulations were interpreted as corresponding to the biliary tree. An explanation for the separation of the activity into three depots, is proposed.
Analysis of the time-activity curves of the accumulations showed an irregular exchange of activity, suggesting intracholedochal movements of bile. Passage of bile from the common duct into the duodenum was observed 1–7 times during the 1-h studies. In most studies the bulk of the activity was caught by an antegrade peristaltic wave as soon as it left the duct. The activity was then transported rapidly in a medial direction. This finding suggests that relaxation of the sphincter occurs in phase with duodenal peristalsis.
KeywordsPublic Health Bile Duct Nuclear Medicine Cholecystitis Acute Cholecystitis
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- 1.Benevenanto TC, Jacobson HG, Hurwitt ES, Schein CJ (1967) Cinecholangiomanometry: Physiologic observation. AJR 100:673–679Google Scholar
- 2.Burnett W, Shields R (1958) Movements of the common bile duct in man. Studies with the image intensifier. Lancet II:387–390Google Scholar
- 3.Caroli J (1977) Contribution to the study of the functioning of Oddi's sphincter. The sphincter of Oddi, Karger, Basel, pp 48–51Google Scholar
- 4.Copeman SM (1889) Unique case of biliary fistula, with some observations on the bile obtained from it. Lancet I:1026, 1075 as cited by Burnett W and Shields R (2)Google Scholar
- 5.Daniels BT, McGlone FB, Job H, Sawyer RF (1961) Changing concepts of common bile duct anatomy and physiology. JAMA 178:394–397Google Scholar
- 6.Hand BH (1973) Anatomy and function of the extrahepatic biliary system. Clin Gastroenterol 2:3–30Google Scholar
- 7.Lamargue JL, Bruel JM, Dondelinger R, Senac JP, Polge D, Rabischong P, Bonnel F (1977) Radioanatomy of the sphincter of Oddi in medical cholangiography. In: The sphincter of Oddi. Karger, Basel, pp 30–35Google Scholar
- 8.MacDonald D (1941) Common bile duct peristalsis — preliminary report. Surg Gynecol Obstet 73:864–866Google Scholar
- 9.Mahour GH, Wakim KG, Soule EH, Ferris DO (1967) Structure of the common bile duct in man: Presence or absence of smooth muscle. Ann Surg 166:91–94Google Scholar
- 10.Nebesar RA, Pollard JJ, Potsaid MS (1966) Cine-cholangiography: Some physiologic observations. Radiology 86:475–479Google Scholar