[Perendoscopic biliary manometry].
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In a medical literature revision, actual concepts about esophageal inferior sphincter's importance are presented. It is the principal object on studies about clinical and surgical therapeutic procedures for gastroesophageal reflux. Thus, esophageal manometric study, fundamental for physiological knowledge of the organ, conducts the reflux esophagitis therapy.
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In order to establish the animal model of papillary insufficiency, 10% formalin solution (0.5-1.0 ml) was injected into duodenal papillae just after cholecystectomy in ten dogs. The bile duct pressure of the dogs was monitored by the manometer utilizing the saline perfusion system. Persistent dilatation of the bile duct was observed postoperatively. Two weeks after operation, the maximum dilatation of the bile duct was observed. The bile duct pressure of the dogs showed several characteristic changes: 1) the perfused pressure increased rapidly just after saline perfusion and then became stable, 2) the dumping time was shorter than that of the control dogs, 3) the residual pressure was lower than that of the control dogs. A metal sound, 4mm in diameter, was passed through the duodenal papillae of the dogs with ease. After injection of 10% formalin solution, macroscopic findings of the duodenal papillae revealed the diminish of their protrusions. These results demonstrated that the pathophysiology of the duodenal papillae treated with 10% formalin solution in this animal model is quite similar to that of human papillary insufficiency.
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