Skip to main content
SpringerLink
Log in

Certain aspects of normal and abnormal motility of sphincter of Oddi

  • Review Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Applications of electromyographic and endoscopic manometric techniques in experimental and clinical studies have enhanced our knowledge of the normal physiology and motility disturbances of the sphincter of Oddi. The sphincter of Oddi has an active role in coordinating the time and rate of secretion of biliopancreatic juice into the duodenum. In the opossum, the sphincter of Oddi exhibits spontaneous contractions that migrate distally along the sphincter and expels its contents into the duodenum. Although the motor activity of the sphincter of Oddi is independent from that of the duodenum, there is a correlation between the frequency of bursts of spike potentials in the sphincter of Oddi and the migrating motor complex phases in the duodenum. Abnormal motility of the sphincter of Oddi has been reported during endoscopic manometric evaluation of patients with choledocholithiasis and sphincter of Oddi dyskinesia. Patients with common bile duct stones have an increase in the frequency of retrograde propagation of phasic waves. Elevation of basal pressure as well as an increase in the frequency and amplitude of sphincter of Oddi phasic waves and the common bile duct-duodenum gradient pressure may occur in patients with sphincter of Oddi dyskinesia. Endoscopic manometric studies of the sphincter of Oddi may become an important method to diagnose sphincter of Oddi dyskinesia.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hendrickson WF: A study of the musculature of the entire extrahepatic biliary system, including that of the duodenal portion of the common bile duct and of the sphincter. Johns Hopkins Hosp Bull 9:223–231, 1898

    Google Scholar 

  2. Oddi R: D'une disposition a sphincter speciale de L'ouverture due canal cholidogue. Arch Ital Biol 8:317–322, 1887

    Google Scholar 

  3. Mann FC, Higgins GM: A physiologic consideration of the sphincter of the ductus choledochus. Proc Soc Exp Biol Med 24:533–534, 1927

    Google Scholar 

  4. Lamarque JL, Bruel JM, Dondelinger R, Senac JP, Polge D, Rabischong P, Bonnell F: Radioanatomy of the sphincter of Oddi in medical cholangiography.In The Sphincter of Oddi. J Delmont (ed). Basel, S Karger AG, 1977, pp 30–35

    Google Scholar 

  5. 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 

  6. Becker JM, Moody FG, Zinsmeister AR: Effect of gastrointestinal hormones on the biliary sphincter of the opossum. Gastroenterology 82:1300–1307, 1982

    Google Scholar 

  7. Toouli F, Dodds WJ, Honda R, Sarna S, Hogan WJ, Komarowski RA, Linehan JH, Arndorfer RC: Motor function of the opossum sphincter of Oddi. J Clin Invest 71:208–220, 1983

    Google Scholar 

  8. Coelho JCU, Moody FG, Senninger N: A new method for correlating pancreatic and biliary duct pressures and sphincter of Oddi electromyography. Surgery 97:342–349, 1985

    Google Scholar 

  9. Coelho JCU, Moody FG, Senninger N, Li YF: Effects of gastrointestinal hormones on Oddi's sphincter and duodenal myoelectric activity and pancreatobiliary pressure. Arch Surg 120:1060–1064, 1985

    Google Scholar 

  10. Hand BH: An anatomical study of the choledochoduodenal area. Br J Surg 1:486–494, 1963

    Google Scholar 

  11. Boyden EA: The sphincter of Oddi in man and certain representative mammals. Surgery 1:25–37, 1937

    Google Scholar 

  12. Gregg JA, Carr-Locke DL: Endoscopic pancreatic and biliary manometery in pancreatic, biliary, and papillary disease, and after endoscopic sphincterotomy and surgical sphincteroplasty. Gut 25:1247–1254, 1984

    Google Scholar 

  13. Schwegler RA, Boyden EA: The development of the pars intestinalis of the common bile duct in the human fetus with special reference to the origin of the ampulla of Vater and the sphincter of Oddi. The origin and involution of the ampulla. Anat Rec 67:441–467, 1937

    Google Scholar 

  14. Ishioka T: Electromyographic study of the choledochoduodenal junction and duodenal wall muscle. Tohoku J Exp Med 70:73–84, 1959

    Google Scholar 

  15. Ono K, Watanabe N, Suzuki K, Tsuchida H, Sugiyama Y, Abo M: Bile flow mechanism in man. Arch Surg 96:869–874, 1968

    Google Scholar 

  16. Sarles JC, Midejean A, Devaux MA: Electromyography of the sphincter of Oddi. Am J Gastroenterol 63:221–231, 1975

    Google Scholar 

  17. Szurszewski JH: A migrating electric complex of the canine small intestine. Am J Physiol 217:1757–1763, 1969

    Google Scholar 

  18. Honda R, Toouli J, Dodds WJ, Sarna S, Hogan WJ, Itoh Z: Relationship of sphincter of Oddi spike bursts to gastrointestinal myoelectric activity in conscious opossums. J Clin Invest 69:770–778, 1982

    Google Scholar 

  19. Code CF, Marlett JA: The interdigestive myoelectric complex of the stomach and small bowel of dogs. J Physiol 246:289–309, 1975

    Google Scholar 

  20. Itoh Z, Takahashi T: Periodic contractions of the canine gallbladder during the interdigestive state. Am J Physiol 240:G183-G189, 1981

    Google Scholar 

  21. Traynor OJ, Dozois RR, DiMagno EP: Canine interdigestive and postprandial gallbladder motility and emptying. Am J Physiol 246:G426-G432, 1984

    Google Scholar 

  22. Vantrappen G, Peeters TL, Janssens J: The secretory component of the interdigestive migrating motor complex in man. Scand J Gastroenterol 14:663–667, 1979

    Google Scholar 

  23. Scott RB, Strasberg SM, El-Scharkawy TY, Diamant NE: Fasting canine biliary secretion and the sphincter of Oddi. Gastroenterology 87:793–804, 1984

    Google Scholar 

  24. Takahashi I, Dodds WJ, Itoh Z, Hogan WJ, Kern MK: Influence of transsphincteric fluid flow on spike burst rate of the opossum sphincter of Oddi. Gastroenterology 87: 1292–1298, 1984

    Google Scholar 

  25. De Wever I, Eckhout C, Vantrappen G, Hellemans J: Disruptive effect of test meals on interdigestive motor complex in dogs. Am J Physiol 235:E661-E665, 1978

    Google Scholar 

  26. Coelho JCU, Gouma DJ, Moody FG, Schlegel JF: The effect of feeding on myoelectric activity of the sphincter of Oddi and gastrointestinal tract in the opossum. Dig Dis Sci 31:202–207, 1986

    Google Scholar 

  27. DuBois FS, Hunt EA: Peristalsis of the common bile duct in the opossum. Anat Rec 53:387–398, 1932

    Google Scholar 

  28. Coelho JCU, Moody FG, Senninger N, Li YF: Sphincter of Oddi and duodenum electromyography and common duct and pancreatic duct pressures in the conscious opossum. Surg Forum 35:219–221, 1984

    Google Scholar 

  29. Hess W: Physiology.In Surgery of the Biliary Passages and the Pancreas. W Hess (ed). Princeton, Van Nostrand, 1965, pp 33–48

    Google Scholar 

  30. Csendes A, Kurse A, Funch-Jensen P, Oster MJ, Ornsholt 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 

  31. Carr-Locke DL, Gregg JA: Endoscopic manometry of pancreatic and biliary sphincter zones in man. Basal results in healthy volunteers. Dig Dis Sci 26:7–15, 1981

    Google Scholar 

  32. Meshkinpour H, Mollot M, Eckerling GB, Bookman L: Bile duct dyskinesia. Clinical and manometric study. Gastroenterology 87:759–762, 1984

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  35. Weisbrodt NW, Copeland EM, Kearley RW, Moore EP, Johnson LR: Effects of pentagastrin on electrical activity of small intestine of the dog. Am J Physiol 227:425–429, 1974

    Google Scholar 

  36. Honda R, Toouli J, Dodds WJ, Geenen JE, Hogan WJ, Itoh Z: Effect of enteric hormones on sphincter of Oddi and gastrointestinal myoelectric activity in fasted conscious opossums. Gastroenterology 84:1–9, 1983

    Google Scholar 

  37. Persson CGA, Ekman M: Effect of morphine, cholecystokinin and sympathomimetics on the sphincter of Oddi and intramural pressure in cat duodenum. Scand J Gastroenterol 7:345–351, 1972

    Google Scholar 

  38. Hedner P, Rorsman G: On the mechanism of action for the effect of cholecystokinin on the choledochoduodenal junction on the cat. Acta Physiol Scand 76:248–254, 1969

    Google Scholar 

  39. Behar J, Biancani P: Effect of cholecystokinin and the octapeptide of cholecystokinin on the feline sphincter of Oddi and gallbladder. J Clin Invest 66:1231–1239, 1980

    Google Scholar 

  40. Toouli J, Watts JM: Actions of cholecystokinin/pancreozymin, secretin and gastrin on extrahepatic biliary tract motilityin vitro. Ann Surg 175:439–447, 1972

    Google Scholar 

  41. Hogan W, Geenen J, Dodds W, Toouli J, Venu R, Helm J: Paradoxical motor response to cholecystokinin (CCK-OP) in patients with suspected sphincter of Oddi dysfunction. Gastroenterology 82:1085, 1982

    Google Scholar 

  42. Nardi GL, Acosta JM: Papillitis as a cause of pancreatitis and abdominal pain. Ann Surg 164:611–621, 1966

    Google Scholar 

  43. Moody FG, Becker JM, Potts JR: Transduodenal sphincteroplasty and transampullary septectomy for postcholecystectomy pain. Ann Surg 197:627–636, 1983

    Google Scholar 

  44. Sherlock S: Gallstones and inflammatory gallbladder disease.In Diseases of the Liver and Biliary System. S Sherlock (ed). Oxford, Blackwell Scientific, 1981, pp 476–498

    Google Scholar 

  45. 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

    Google Scholar 

  46. Gregg JA, Antal RD: Rhythm abnormalities of the biliary and pancreatic sphincters: Diagnosis by endoscopic manometry. Am J Surg 148:602–606, 1984

    Google Scholar 

  47. Vantrappen G, Janssens J, Hellemans J, Ghoos Y: The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. J Clin Invest 59:1158–1166, 1977

    Google Scholar 

  48. Corazziari E, Torsoli A, De Masi E, Habib FI, Gatti V, Giubilei D, Fegiz GF: Frequency distribution, of human sphincter of Oddi phasic activity. Gastroenterology 86:1054, 1984

    Google Scholar 

  49. De Ridder P: The dilated common duct sign. A potential indication of a sphincter of Oddi dyskinesia. Clin Nucl Med 9:262–263, 1984

    Google Scholar 

  50. Krishnamurthy GT, Bobba VVR, Mesgarzadeh M, McConnell D, Kingston E: A new quantitative test for biliary dynamics. Clin Nucl Med 6:451, 1981

    Google Scholar 

  51. Bohmer F, Seyss R: Zur diagnose funktioneller storungen der gallenblase und des gallenwegsystem. Wien Klin Wochenschr 94:450–454, 1982

    Google Scholar 

  52. Wong HN, Frey CF, Gagic NM: Intraoperative common duct pressure and flow measurements. Am J Surg 139: 691–695, 1985

    Google Scholar 

  53. White TT, Waisman H, Hopton D, Kavlie H: Radiomanometry, flow rate, and cholangiography in the evaluation of common bile duct disease. Am J Surg 123:73–79, 1972

    Google Scholar 

  54. Toouli J, Geenen JE, Hogan WJ, Dodds WJ, Arndorfer RC: Sphincter of Oddi motor activity: A comparison between patients with common bile ducts stones and controls. Gastroenterology 82:111–117, 1982

    Google Scholar 

  55. De Masi E, Corazziari E, Habib FI, Fontana B, Gatti V, Fegiz GF, Torsoli A: Manometric study of the sphincter of Oddi in patients with and without common bile duct stones. Gut 25:275–278, 1984

    Google Scholar 

  56. Tanaka M, Ikeda S, Nakayama F: Continuous measurement of common bile duct pressure with an indwelling microtransducer catheter introduced by duodenoscopy: New diagnostic aid for postcholecystectomy dyskinesia — a preliminary report. Gastrointest Endosc 29:83–88, 1983

    Google Scholar 

  57. Tanaka M, Ikeda S, Nakayama F: Nonoperative measurement of pancreatic and common bile duct pressures with a microtransducer catheter and effects of duodenoscopic sphincterotomy. Dig Dis Sci 26:545–552, 1981

    Google Scholar 

  58. Gregg JA, Taddeo AE, Milano AF, McCartney AJ, Santoro BT, Frager SH, Capobianco AG: Duodenoscopy and endoscopic pancreatography in patients with positive morphine-prostigmine tests. Am J Surg 134:318–321, 1977

    Google Scholar 

  59. LoGiudice JA, Geenen JE, Hogan WJ, Dodds WJ: Efficacy of the morphine-prostigmine test for evaluating patients with suspected papillary stenosis. Dig Dis Sci 24:455–458, 1979

    Google Scholar 

  60. Classen M: Endoscopic approach to papillary stenosis. Endoscopy 13:154–156, 1981

    Google Scholar 

  61. Roberts-Thomson IC, Toouli J: Endoscopic sphincterotomy for biliary dyskinesia. Gastrointest Endosc 30:141, 1984

    Google Scholar 

  62. Ell C, Geocze S, Riemann JF: Successful endoscopic treatment of extensive recurrent papillary stenosis six years after endoscopic papillotomy. Endoscopy 16:246–248, 1984

    Google Scholar 

  63. Riemann JF, Lux G, Forster P, Altendorf A: Long-term results after endoscopy papillotomy. Endoscopy 15:165–168, 1983

    Google Scholar 

  64. Geenen JE, Toouli J, Hogan WJ, Dodds WJ, Stewart ET, Mavrelis P, Riedel D, Venu R: Endoscopic sphincterotomy: Follow-up evaluation of effects on the sphincter of Oddi. Gastroenterology 87:754–758, 1984

    Google Scholar 

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

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, The University of Texas Medical School at Houston, 6431 Fannin, Suite 4164, 77030, Houston, Texas

    Julio C. U. Coelho MD, PhD & Frank G. Moody MD

Authors
  1. Julio C. U. Coelho MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frank G. Moody MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Coelho, J.C.U., Moody, F.G. Certain aspects of normal and abnormal motility of sphincter of Oddi. Digest Dis Sci 32, 86–94 (1987). https://doi.org/10.1007/BF01296692

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01296692

Keywords

Search

Navigation