Abstract
The morphine-Prostigmin test (MPT) has been advocated as a diagnostic test for identifying patients with papillary stenosis. We studied 14 patients referred for possible papillary stenosis with the MPT and ERCP sphincter of Oddi manometry. The response to the MPT (symptoms, serum amylase/lipase values) was evaluated by multiple criteria. The MPT was also done on 6 volunteer control subjects. Operative evaluation of the sphincter of Oddi was obtained in 8 of the 14 patients. There was no correlation between the results of the MPT and ERCP manometry or operative findings. There was good correlation, however, between ERCP manometric findings and operative assessment of the sphincter of Oddi. Fifty percent of the volunteer subjects had a significantly positive enzyme response to the MPT. In our experience the MPT does not reliably detect patients with papillary stenosis.
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Cattell RB, Colcock BP, Pollock JL: Stenosis of the sphincter of Oddi. N Engl J Med 256:429–435, 1973
Nardi GL: Papillitis and stenosis of the sphincter of Oddi. Surg Clin N Am 53:1147–1160, 1973
White TT: The part that the sphincter of Oddi plays in the etiology of pancreatitis. The sphincter of Oddi, Proceedings of the 3rd Gastroenterology Symposium, Nice, 1976, Basel, Karger, 1977, pp 175–179
Nardi GL, Acosta JM: Papillitis as a cause of pancreatitis and addominal pain. Ann Surg 164:611–618, 1966
Bar-Meir S, Geenen JE, Hogan WJ, Dodds WJ, Stewart ET, Arndorfer RC: Biliary and pancreatic duct pressures measured by ERCP manometry in patients with suspected papillary stenosis. Dig Dis Sci 24:209–213, 1979
McCarthy, JD: Radiomanometric guides to common bile duct exploration. Am J Surg 134:697–701, 1977
White TT, Waisman H, Hopton D, Karbie H: Radiomanometry, flow rates and cholangiography in the evaluation of common bile duct disease. Am J Surg 123:73–79, 1972
Gullick HD: Relation of the magnitude of blood enzyme elevation to severity of exocrine pancreatic disease. Am J Dig Dis 18:375–383, 1973
Gregg JA, Taddeo AE, Milano AF: Duodenoscopy and endoscopic pancreatography in patients with positive morphine prostigmin tests. Am J Surg 134:318–321, 1977
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LoGiudice, J.A., Geenen, J.E., Hogan, W.J. et al. Efficacy of the morphine-prostigmin test for evaluating patients with suspected papillary stenosis. Digest Dis Sci 24, 455–458 (1979). https://doi.org/10.1007/BF01299827
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DOI: https://doi.org/10.1007/BF01299827