Simultaneous Measurement of Choledochal and Pancreatic Sphincter Motility ; Comparative Study of Manometric Parameters

Min, Young Il; Lee, Sung Koo; Kim, Myung Hwan; Seo, Dong Wan; Lee, Me Hwa; Yoo, Byeong Moo; Myung, Seung Jae; Min, Young Joo; Park, Hyo Sook; Jung, Sung Ae

Abstract

If manometric profiles of sphincter of Oddi(SO) measured from the pancreatic duct and the bild duct are essentially equal, then measurement of manometric profiles from only one duct would be adequate in evaluating SO dysfunction. We report a series of 9 patients whom we evaluate with SO manometry. Cannulation of both the biliary sphincter segment and pancreatic sphincter segment was archived consecutively in one session and we compared the manometric parameters of choledochal sphincter from those of pancreatic sphincter. 1) In 7 out of 9 patients(78%), normal manometric finding of SO were seen in both choledochal and pancreatic sphincters. However, in 2 out of 9 cases(22%) abnormal manometric findings were noted in only one sphincter segment. Elevation of basal pressure(n = l) and increased retrograde propagation(n = 1) were found in the pancreatic sphincter segment alone. 2) Tbe mean intraductal pressure in the pancreatic duct was significantly greater(12.6+/- 5.8mmHg) than that of common bile duct(3.8+/- 3.3mmHg)(p<0.01). However, basal pressure, amplitude, frequency and propagation sequence in the phasic contraction of SO were not different significantly between choledochal and pancreatic sphincter segment. In conclusion, SO manometry of both the pancreatic and bile duct is needed if complete manometric information is desired. Selective cannulation of common bile duct and pancreatic duct during SO manometry is necessary in order to diagnose segmental 50 dysfunction.