Gut 2001;48:414-417
( March )
Article
Increased sphincter of Oddi basal pressure in patients affected
by gall stone disease: a role for biliary stasis and colicky
pain?
M Cicalaa, F I Habibb, F Fioccac, N Pallottab, E Corazziarib
a Gastroenterologia,
Libera Università Campus Bio Medico, Roma, Italy, b Cattedra di Gastroenterologia I, Dipartimento di
Scienze Cliniche, Roma, Italy, c II Clinica Chirurgica,
Università La Sapienza, Roma, Italy
Correspondence to: Dr M Cicala, Area di
Gastroenterologia, Libera Università "Campus Bio-Medico", Via
Longoni, 83-00155 Roma, Italy.
m.cicala{at}unicampus.it
Accepted for publication 2 October 2000
BACKGROUND AND
AIMS
Even if the motor activity of the gall
bladder and sphincter of Oddi (SO) are integrated, it is not known if
the presence of stones in the gall bladder affects SO function. The aim
of the study was to compare SO motor activity in patients with and without gall stones.
PATIENTS AND
METHODSIn a series of 155 patients consecutively
submitted to endoscopic retrograde cholangiopancreatography and SO
manometry for suspected biliary or pancreatic disease, 23 gall stone
patients had recurrent episodes of biliary or pancreatic pain (colicky group); 52 patients had non-biliary/pancreatic-type abdominal pain/discomfort, and of these, 15 had gall stones (non-colicky group),
25 were free of stones (controls), and 12 had undergone cholecystectomy.
RESULTSSO basal
pressure in gall stone patients in the colicky or non-colicky group was
significantly higher than in controls (p<0.001). SO basal pressure
recorded in postcholecystectomy patients did not differ from controls.
SO phasic activity did not differ between the patient groups. SO
dysfunction was detected in more than 40% of gall stone patients
irrespective of associated biliary/pancreatic pain but in none of the
control subjects (p<0.001).
CONCLUSIONSGall
stones are frequently associated with increased SO tone which may
obstruct bile flow thus acting to facilitate gall bladder stasis, and
may play a role as a cofactor in biliary/pancreatic pain.
Keywords:
biliary pain;
gall bladder;
gall stone disease;
sphincter of Oddi
© 2001 by Gut
