Preserved function of the Oddi sphincter after endoscopic papillary balloon dilation.
OBJECTIVE
Endoscopic papillary balloon dilation (EPBD) is a safe and effective procedure for the treatment of bile duct stones that appears to be less hazardous to the sphincter of Oddi than endoscopic sphincterotomy. However, little is known about the function of Oddi muscle after EPBD. The aim of the present study is to evaluate Oddi muscle function using quantitative cholescintigraphy.


METHODS
This study was conducted using 12 patients treated for bile duct stones by EPBD, and 8 patients treated by endoscopic sphincterotomy, followed by laparoscopic cholecystectomy thereafter. For the controls, 10 asymptomatic cholecystectomized patients were used. From 1-3 years after the interventional procedures, patients received a quantitative cholescintigraphy examination using 185 MBq of technetium-99m-N-pyridoxyl-5-methyl-tryptophan. The hepatic hilum-duodenum transit time on quantitative cholescintigraphy was measured as the time interval between the initial appearance of isotope activity at the hepatic hilum and that at the duodenum.


RESULTS
Mean hilum-duodenum transit time in patients after EPBD (6.3 min, 95%CI 4.5-8.0) was not different from that in control patients (6.5 min, 95%CI 4.3-8.7), whereas mean hilum-duodenum transit time in endoscopic sphincterotomy patients (3.2 min, 95%CI 2.4-4.0) was markedly shorter than both the control and EPBD groups (p = 0.0053).


CONCLUSIONS
The function of the sphincter of Oddi may be preserved after endoscopic papillary balloon dilation.
Isayama
Hiroyuki
H
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. isayama-2im@h.u-tokyo.ac.jp
Komatsu
Yutaka
Y
Inoue
Yusuke
Y
Toda
Nobuo
N
Shiratori
Yasushi
Y
Tsujino
Takeshi
T
Yamada
Hisashi
H
Saitou
Keiji
K
Kawabe
Takao
T
Omata
Masao
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000502:physiology; D001652:Bile Ducts / Q000000981:diagnostic imaging; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D015331:Cohort Studies; D004386:Duodenum / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011730:Pyridoxal / Q000031:analogs & derivatives*; D011877:Radionuclide Imaging / Q000295:instrumentation; D009803:Sphincter of Oddi / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome; D014364:Tryptophan / Q000031:analogs & derivatives*
D015609:Organotechnetium Compounds; C038081:technetium Tc 99m pyridoxyl-5-methyltryptophan; D011730:Pyridoxal; D014364:Tryptophan