Skip to main content
Log in

Nonoperative measurement of pancreatic and common bile duct pressures with a microtransducer catheter and effects of duodenoscopic sphincterotomy

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Duodenoscopic manometry of the pancreatic duct (PD_ and common bile duct (CBD) using a microtransducer catheter has distinct advantages over infusion manometry, giving absolute values ofin situ intraluminal pressure. Microtransducer manometry was performed without medication in 49 patients with gallbladder stones (10), common bile duct stones (24), hepatic duct stones (6) and common bile duct dilatation (9), and was successful in 42 (86%) for PD and 36 (73%) for CBD. Ductal pressures showed respiration-synchronized biphasic variations superimposed by the arterial pulsation effect. Considerable postural change of the pressure values suggested that the recording posture should be predetermined. The PD-to-duodenum pressure gradient was higher than the CBD-to-duodenum gradient in most cases. Both were lower than those obtained previously by infusion methods. No significant differences were found in pressure profiles of the four disease groups. Endoscopic sphincterotomy significantly reduced not only CBD pressure but also PD pressure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Nebel OT: Manometric evaluation of the papilla of Vater. Gastrointest Endosc 21:126–128, 1975

    Google Scholar 

  2. Rösch W, Koch H, Demling L: Manometric studies during ERCP and endoscopic papillotomy. Endoscopy 8:30–33, 1976

    Google Scholar 

  3. Weiss H-D, Kramann B, Wuttke V, Anacker H: Der Basisdruck im Ductus pancreaticus und Ductus choledochus. Med Klin 72:519–523, 1977

    Google Scholar 

  4. Bradley VD, Nebel OT: Clinical evaluation of sphincter of Oddi manometry. Gastrointest Endosc 24:27–29, 1977

    Google Scholar 

  5. Geenen JE, Hogan WJ, Schaffer RD, Stewart ET, Dodds WJ, Arndorfer RC: Endoscopic electrosurgical papillotomy and manometry in biliary tract disease. J Am Med Assoc 237:2075–2078, 1977

    Google Scholar 

  6. Hogan WJ, Dodds WJ, Geenen JE, Schaffer RD, Stewart ET, Arndorfer RC: Sphincter of Oddi motor activity in man: A zone of unique, phasic high-pressure contractions (abstract)In Gastrointestinal Motility in Health and Disease, HL Duthie, (ed). Lancaster, England, MTP Press, 1978, pp 593–594

    Google Scholar 

  7. Bar-Meir S, Geenen JE, Hogan WJ, Dodds WJ, Stewart ET, Arndorfer RC: Biliary and pancreatic duct pressure measured by ERCP manometry in patients with suspected papillary stenosis. Dig Dis Sci 24:209–213, 1979

    Google Scholar 

  8. Funch-Jensen P, Csendes A, Kruse A, Øster MJ, Amdrup E: Common bile duct and Oddi sphincter pressure before and after endoscopic papillotomy in patients with common bile duct stones. Ann Surg 190:176–178, 1979

    Google Scholar 

  9. Csendes A, Kruse A, Funch-Jensen P, Øster MJ, Ørnsholt J, Amdrup E: Pressure measurements in the biliary and pancreatic duct systems in controls and in patients with gallstones, previous cholecystectomy, or common bile duct stones. Gastroenterology 77:1203–1210, 1979

    Google Scholar 

  10. Geenen JE, Hogan WJ, Dodds WJ, Stewart ET, Arndorfer RC: Intraluminal pressure recording from the human sphincter of Oddi. Gastroenterology 78:317–324, 1980

    Google Scholar 

  11. von Vondrasek P, Eberhardt G: Endoskopische Druckmessungen mittels Halbleitertechnik. Z Gastroenterol 12:453–458, 1974

    Google Scholar 

  12. Mitani E, Kobayashi K, Yamada H: Clinical studies on endoscopic manometry of the choledochus and the pancreatic duct by means of micromanometer. Gastroenterol Endosc 18:889–892, 1976 (Japanese)

    Google Scholar 

  13. Classen M, Demling L: Endoscopic sphincterotomy of the papilla of Vater and extraction of stones from the choledochal duct. Dtsch Med Wochenschr 99:496–497, 1974

    Google Scholar 

  14. Kawai K, Nakajima M, Kimoto K, Sugawara K, Fukumoto K: Endoscopic sphincterotomy of the ampulla of Vater. Endoscopy 7:30–35, 1975

    Google Scholar 

  15. Safrany L: Duodenoscopic sphincterotomy and gallstone removal. Gastroenterology 72:338–343, 1977

    Google Scholar 

  16. Ikeda S, Tanaka M, Itoh H, Tamura R: A newly devised cutting probe for endoscopic sphincterotomy of the ampulla of Vater. Endoscopy 9:238–241, 1977

    Google Scholar 

  17. Ikeda S, Itoh H, Tanaka M: Endoscopic sphincterotomy and extraction of gallstones. Stomach Intestine 15:667–678, 1980

    Google Scholar 

  18. Hauge CW, Mark JBD: Common bile duct motility and sphincter mechanism: I. Pressure measurements with multiple-lumen catheter in dogs. Ann Surg 162:1028–1038, 1965

    Google Scholar 

  19. Stef JJ, Dodds WJ, Hogan WJ, Linehan JH, Stewart ET: Intraluminal esophageal manometry: An analysis of variables affecting recording fidelity of peristaltic pressures. Gastroenterology 67:221–230, 1974

    Google Scholar 

  20. Jones SA, Steedman RA, Keller TB, Smith LL: Transduodenal sphincteroplasty (not sphincterotomy) for biliary and pancreatic disease. Am J Surg 118:292–306, 1969

    Google Scholar 

  21. Doubilet H, Mulholland JH: Eight-year study of pancreatitis and sphincterotomy. J Am Med Assoc 160:521–528, 1956

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tanaka, M., Ikeda, S. & Nakayama, F. Nonoperative measurement of pancreatic and common bile duct pressures with a microtransducer catheter and effects of duodenoscopic sphincterotomy. Digest Dis Sci 26, 545–552 (1981). https://doi.org/10.1007/BF01308105

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01308105

Keywords

Navigation