Frequency of papillary dysfunction among cholecystectomized patients.
Four hundred and fifty-four consecutive patients who had had their gallbladder removed were interviewed to determine the presence of upper abdominal pain, increased serum alkaline phosphatase and/or serum amylase activity. Patients with unexplained upper abdominal pain and/or enzyme abnormalities were offered endoscopic retrograde cholangiopancreatography (ERCP) and manometric evaluations. Dysfunction of the sphincter of Oddi diagnosed by ERCP manometry may account for the abdominal pain seen in 14% of the patients with postcholecystectomy syndrome. It may rarely be the cause of an elevated serum alkaline phosphatase and/or amylase when abdominal pain is not present. Papillary dysfunction is seen in less than 1% of the patients who have had their gallbladders removed. ERCP manometry is recommended in cholecystectomized patients with unexplained abdominal pain suggesting pancreaticobiliary origin.
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D014670:Ampulla of Vater / Q000503:physiopathology*; D000681:Amylases / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000009:adverse effects*; D003137:Common Bile Duct Diseases / Q000201:enzymology / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D009803:Sphincter of Oddi / Q000503:physiopathology*
D000469:Alkaline Phosphatase; D000681:Amylases