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Endoscopic manometry of pancreatic and biliary sphincter zones in man

Basal results in healthy volunteers

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Abstract

An endoscopic manometric technique was applied to the study of intraductal biliary and pancreatic pressures and sphincter activity in normal subjects. A perfused system using a modified endoscopic retrograde cholangiopancreatography catheter was tested and found to provide reliable ductal and phasic recordings. Twenty-five healthy volunteers aged 19–37, underwent endoscopic manometry under diazepam sedation. Distinct zones of high-pressure phasic activity were identified on pull-through from the pancreatic duct and common bile duct at mean distances of 4.5 and 5.0 mm, respectively, from the papillary orifice with frequencies of 7.0±1.8 (mean±sd) and 5.6±2.4 waves/min, respectively. These were considered to represent separate pancreatic duct and bile duct sphincters. Peak pancreatic duct sphincter pressure (47.6±8.2 mm Hg) and bile duct sphincter pressure (57.2±10.7 mm Hg) were similar. Pancreatic duct pressure was 11.4±3.0. mm Hg and common bile duct pressure was 3.0±2.5 mm Hg. Values were adjusted to duodenal pressure as zero reference. The ductal and sphincteric pressures reported in this study provide a basis for the assessment of physiological, pharmacological, pathophysiological, and surgical effects on this area.

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Authors and Affiliations

  1. New England Baptist Hospital, Boston, Massachusetts

    David L. Carr-Locke MRCP (UK) & James A. Gregg MD

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  1. David L. Carr-Locke MRCP (UK)
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  2. James A. Gregg MD
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This work was supported by grants from the Katherine Gavriluk and Sara Jordan Funds, New England Baptist Hospital, Boston, Massachusetts, and Dr. Carr-Locke is in receipt of grants from the Wellcome Research Travel Fund, London, England, the Leicester Area Health Authority, Leicester, England, and the P and C Hickinbotham Trust, Leicester, England.

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Carr-Locke, D.L., Gregg, J.A. Endoscopic manometry of pancreatic and biliary sphincter zones in man. Digest Dis Sci 26, 7–15 (1981). https://doi.org/10.1007/BF01307970

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  • DOI: https://doi.org/10.1007/BF01307970

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