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首页> 外文期刊>Journal of hepato-biliary-pancreatic surgery >Advances in research and clinical practice in motor disorders of the sphincter of Oddi.
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Advances in research and clinical practice in motor disorders of the sphincter of Oddi.

机译：Oddi括约肌运动障碍的研究和临床实践进展。

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摘要

Perfusion manometry of the sphincter of Oddi (SO) using a pneumohydraulic capillary infusion system records phasic wave activity superimposed on basal pressure. A triple-lumen catheter allows the recording of propagation of the phasic waves. Microtransducer manometry is an alternative that permits prolonged recording of biliary pressure without the need for infusion. A cyclic change is recognized in SO motility in coordination with the migrating motor complex (MMC) of the duodenum during fasting. SO contractions occur at maximal frequency and amplitude during phase 3 of the duodenal MMC. Using two microtransducer catheters placed by duodenoscopy, a cyclic elevation of biliary pressure can be recorded in concert with phase 3. These findings indicate that human SO contractions impede bile flow. SO dysfunction causing biliary-type pain can be diagnosed by manometry. The pressure elevation during phase 3 may contribute to the development of pain in patients with biliary dyskinesia. Gastrectomy and proximalduodenal transection were proven to affect sphincter motility, as evidenced by the paradoxical response to cholecystokinin. Choledocholithiasis and hepatolithiasis are associated with low basal pressure, presumably due to repeated injury to the sphincter by passing stones. SO and biliary manometry leads to better understanding of biliary dynamics and the pathophysiology of biliary diseases.
机译：使用气动液压毛细管输注系统对Oddi（SO）括约肌进行灌注测压，记录相波活动叠加在基础压力上。三腔导管允许记录相波的传播。微换能器测压法是一种替代方法，无需输注即可长时间记录胆道压力。在禁食期间，SO动力与十二指肠的迁移运动复合物（MMC）协同作用可识别出周期性变化。 SO收缩在十二指肠MMC的第3阶段以最大频率和振幅发生。使用通过十二指肠镜放置的两个微换能器导管，可以记录与阶段3一致的胆道压力的周期性升高。这些发现表明，人SO收缩会阻碍胆汁流动。可以通过测压法诊断导致胆道型疼痛的SO功能障碍。第三阶段的压力升高可能会导致胆汁运动障碍患者的疼痛发展。对胆囊收缩素的反常反应证明，胃切除术和十二指肠近端横断会影响括约肌运动。胆管结石症和肝结石症与低基础压力有关，大概是由于通过结石对括约肌的反复伤害。 SO和胆管测压可以更好地了解胆道动力学和胆道疾病的病理生理。

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