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At least 19 recordsLinked to original sources
PubMed2005

[An experimental study on the gastroantrium-cholecystostomy using pylorus sphincter to replace Oddi sphincter for preventing reflux].

OBJECTIVE: This experimental study of gastroantrium-cholecystostomy was designed to identify the possible use of pylorus sphincter as a substitute for Oddi sphincter. METHODS: Fifteen prairie dogs were randomized to three groups. The dogs in the control group underwent sham operation. The dogs in the first experiment group were subjected to gastroantrium-cholecystostomy and gastrojejunostomy. Meanwhile, two thin tubes were placed in stomach antrium and duodenum separately for post-operative photography. One week after operation, 20% cyctografin (10 ml) was injected into the duodenum through the relevant tube so as to check whether any backflow came out from duodenum to the bile duct. Then, 20% cyctografin (5 ml) was injected into the stomach antrium so as to demonstrate how it went from stomach antrium into duodenum. The samples of liver, stomach, stomach antrium, gallbladder and extra hepatic duct were collected for pathological examinations. The dogs of the second experiment group underwent the same operations, but the samples for pathological examination were collected four weeks after operation. RESULTS: Roentgenography showed that there was no contrast medium backflowing into the stomach antrium, and the contrast medium could flow from stomach antrium into duodenum smoothly. The results of histo-pathological examination showed that there were no obvious changes in the liver, stomach antrium and bile duct. Under light microscope, a few inflammatory cells could be seen in the gallbladder wall, and the mucosa of stomach was slightly atrophic. CONCLUSION: The gastroantrium-cholecystostomy which uses pylorus sphincter to take over the functions of Oddi sphincter can effectively prevent intestinal juice from flowing back into the bile duct.

Anastomosis, Surgical↗
PubMed1994

Distribution and morphological features of nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) activity in intrinsic neurons of the Oddi sphincter of the cat.

To clarify the role of nitric oxide (NO) in the sphincter of Oddi, we histochemically investigated the distribution of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d), a marker for NO synthase, in the cat. NADPH-diaphorase activity was localized in two neuronal subtypes: large neurons with many dendrites and smaller with one process. Most of the nerve cell bodies (99%) in the wall of the sphincter of Oddi showed strong activity for this enzyme. The nerve fibers with NADPH-d activity were observed in all layers, chiefly in the muscle layers. These results suggest that NO may play a very important role in the neuronal regulation of sphincter of Oddi.

Animals↗
PubMedDate not supplied

Preserved function of the Oddi sphincter after endoscopic papillary balloon dilation.

BACKGROUND/AIMS: 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. METHODOLOGY: 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.

Adult↗
PubMedDate not supplied

[Endoscopic treatment of dyskinesia of the Oddi's sphincter].

Oddi sphincter dysfunction is manifested as a biliary- or pancreatic-type pain syndrome. At present, imaging studies are not very trustworthy for the diagnosis of this dysfunction, because of which direct endoscopic manometry offers the gold standard for confirming or ratifying the problem, supported by the Milwaukee Biliary Classification. Currently, the endoscopic approach has become the most effective alternative used for this type of diagnosis. Among the techniques may be found the following: endoscopic sphincterotomy, balloon dilation, the placing of biliary endoprostheses, and the injection of botulinic toxin in the Oddi sphincter. In our modest and short experience with six patients, of which five corresponded to group I of the Milwaukee bile classification, the above patients were treated successfully with sphincterotomy. The other two patients belonged to group type III of the Milwaukee classification, and were treated with botulinic toxin until the moment of a satisfactory response, for a period of 8 months.

Adult↗
PubMedDate not supplied

Oddi sphincter and common channel: evaluation with pharmacodynamic MR cholangiopancreatography using fatty meal and secretin stimulation.

PURPOSE: This study was performed to assess the usefulness of pharmacodynamic MR cholangiopancreatography (MRCP) in depicting the segment covered by the Oddi sphincter. MATERIALS AND METHODS: Twelve volunteers were studied by pharmacodynamic MRCP. After stimulation by the oral intake of a fatty meal and an intravenous injection of secretin, a single-shot rapid acquisition relaxation enhancement (RARE) sequence was used to obtain consecutive images of the segment covered by the Oddi sphincter. The contraction range of the Oddi sphincter and the lengths of the common channel were measured on the MR console by comparing the most contracted image of the sphincter with the most relaxed image. RESULTS: Pharmacodynamic MRCP showed periodic contraction of the Oddi sphincter in all cases. The range of sphincteric contraction over the biliary duct was 8-19 mm (11.8+/-3.2 mm, mean +/- standard deviation) and over the pancreatic duct 8-23 mm (10.0+/-1.5 mm). In 11 of the 12 cases, the common channel was depicted and its length ranged from 3-8 mm (5.2+/-1.3 mm). CONCLUSION: Pharmacodynamic MRCP clearly depicted the range of contraction of the Oddi sphincter and the common channel, which are not usually revealed by conventional MRCP.

Adult↗
PubMed1995

[Management of Oddi sphincter dyskinesis. Results of drug therapy and sphincterotomy].

UNLABELLED: In a retrospective evaluation, the outcome of the long term treatment of the sphincter of Oddi dyskinesia (OD, type III. dysfunction) has been analysed. PATIENTS AND METHOD: Therapeutic results of 64 cholecystectomised patients with OD were evaluated by means of regular follow-up and questionnaire filled in either by the patients or their practitioners. RESULTS: Conservative treatment (nitroglycerin, calcium channel blocker or both) resulted in symptom-free condition or improvement with 53% of the patients (37/64). Out of 27 patients whose condition did not improve by combined drug therapy, in 20 cases endoscopic sphincterotomy (EST) and in 1 case transduodenal sphincterotomy were performed. Having followed sphincterotomy, out of 21 patients only 9 became symptom-free and 5 improved. CONCLUSIONS: Therapeutic benefit of sphincter relaxants fail in nearly half of the cases with OD, and even sphincterotomy can lead to symptomless condition only in a portion of OD. Regarding the high incidence of complications following EST in OD, it can only be recommended after failure of the conservative therapy in correctly diagnosed cases. The results emphasise a need for a prospective randomised controlled clinical study to seek for the optimal therapeutic regimen.

Adult↗
PubMed2003

Oddi sphincter function after canine auto-pancreas transplantation with bladder drainage.

AIM: Several neural and hormonal factors are known to affect motility of sphincter of Oddi (SO). The major roles of SO are to regulate the flow of bile and pancreatic juice into the duodenum and to prevent the reflux of duodenal contents into the biliary and pancreatic duct. After pancreas transplantation, graft SO was denervated and graft pancreatitis might have relations to SO motility. The motility of SO after canine pancreas transplantation with bladder drainage was investigated. METHODS: Normal canine SO manometry and pancreas graft SO manometry after pancreas transplantation with bladder drainage were performed in seven dogs respectively before and after cholecystokinin (CCK) administration. Data of SO basal pressure, contraction frequency, amplitude and motility index after transplantation and CCK administration were compared with that in controls and before CCK administration. RESULTS: SO showed regular contractions with a certain basal pressure in control dogs. After transplantation, the graft SO basal pressure and contraction frequency were higher than that in controls, but the amplitude decreased (P<0.01). There was no great difference in SO motility index. CCK administration could relax normal SO but stimulate graft SO after pancreas transplantation with bladder drainage. After CCK administration, SO basal pressure, frequency and motility index were increased significantly (P<0.05), in comparison with that before administration. The amplitude remained unchanged (P>0.05), in comparison with that before CCK administration. CONCLUSION: After auto-pancreas transplantation with bladder drainage, canine SO motility was inhibited. Basal pressure and frequency increased but amplitude decreased. CCK administration after transplantation had an inhibitory effect on canine SO instead of a relaxation effect observed in normal canine SO. This will increase the resistance of SO to the pancreatic juice flow and induce pancreatic juice stagnation and can not prevent reflux of urine and duodenal contents when the bladder pressure is increased to a certain extent, which may cause graft pancreatitis.

Animals↗
PubMed1979

Common bile duct and Oddi sphincter pressure before and after endoscopic papillotomy in patients with common bile duct stones.

Pressures in the Oddi sphincter and common bile duct were determined before, immediately after and several weeks after endoscopic papillotomy. Fifteen patients were included in the study. Significant decreases in Oddi sphincter and common bile duct pressures were found and the decrease in Oddi sphincter pressure was to some extent dependent upon the length of the papillotomy.

Adult↗
PubMed1985

Antagonism by clonidine of the adenosine-induced inhibition of the twitch contraction of the guinea-pig Oddi sphincter.

The effects of clonidine on the purinergic inhibition of cholinergic transmission were investigated; we used the twitch contraction of a circular segment of the guinea-pig Oddi sphincter stimulated electrically. A circular segment of Oddi sphincter was contracted in a frequency-dependent manner by transmural nerve stimulation. Adenosine (10(-6) to 10(-4] produced a reduction of approximately 40% in the twitch contraction elicited at 5 Hz. The inhibition was antagonized by theophylline (10(-5) M), 8-phenyltheophylline (10(-6) M) or clonidine (10(-6) to 3 X 10(-6) M) but was enhanced by dipyridamole (3 X 10(-6) M). This antagonism produced by clonidine (3 X 10(-6) M) was almost unaffected by yohimbine (3 X 10(-6) M). The twitch contraction was also suppressed by N6-substituted adenosine analogs, L-PIA and CHA. The suppression was counteracted by theophylline or clonidine. The contraction produced by exogenously administered acetylcholine was not affected by clonidine and/or adenosine at all. The results suggest that clonidine, like theophylline, seems to exert these antagonistic effects by acting on the neuronal adenosine receptors in the guinea-pig Oddi sphincter muscle.

Adenosine↗
PubMed1979

Common bile duct pressure and Oddi sphincter pressure in patients with common bile duct stones with and without juxta-ampullar diverticula of the duodenum.

Resting common bile duct pressure and Oddi sphincter pressure were measured in 16 patients with common bile duct stones, 8 having in addition a juxta-ampullar diverticulum. Pressure measurements were performed with an infused catheter introduced through an endoscope under direct vision. No significant differences in fasting common bile duct pressures were observed between the two groups. The Oddi sphincter had a phasic activity, and the peak pressure was similar in both groups.

Aged↗
PubMed1984

The influence of measuring catheter diameter on direct manometry in the canine sphincter of Oddi.

Sphincter of Oddi manometry was performed in three anesthetized dogs, using different measuring catheter diameters, ranging from 1.0 to 1.9 mm. No differences were seen either in sphincter of Oddi wave amplitude, frequency, and base-line pressure or in common bile duct pressure measured after cannulation during 20 min with catheters of 1.0 and 1.3 mm. However, significant disturbances of these variables were present when the measuring catheter diameter was 1.6 and 1.9 mm. It is concluded that the diameter of the recording catheter is of crucial importance in sphincter of Oddi manometry. In dogs with a body weight of 30-40 kg, the outer diameter should not exceed 1.3 mm.

Ampulla of Vater↗
PubMed2004

[The changes of Oddi sphincter motility after canine pancreas transplantation with bladder drainage].

OBJECTIVE: To study the changes of canine Oddi sphincter (SO) function after pancreas transplantation with bladder drainage and the effect on the graft function. METHODS: Normal canine SO, transplant canine SO and canine SO in vitro manometry were performed by triple lumen catheter. At the same time, pancreas endocrine and exocrine function after transplantation were determined. After transplantation, anti-reflux function of graft SO was also measured. RESULTS: Endocrine and exocrine function of all the transplanted dogs showed that pancreas graft function was good. Basal pressure of SO in control group was (18.5 +/- 2.8) mm Hg (1 mm Hg = 0.133 kPa). The contraction frequency was (9.7 +/- 1.5) per min, the contraction amplitude was (47.1 +/- 5.5) mm Hg, the motility index was (236 +/- 56). After transplantation, basal pressure increased to (27.8 +/- 2.8) mm Hg, frequency increased to (13.1 +/- 1.9) per min, amplitude decreased significantly to (8.3 +/- 1.8) mm Hg. There was no significant difference of motility index. Basal pressure of SO in vitro increased significantly to (37.2 +/- 5.1) mm Hg. Phasic contraction was not absent. After transplantation, the pressure in the bile duct residual did not increase in accordance with the increase of bladder pressure. CONCLUSIONS: After pancreas transplantation with bladder drainage, Basal pressure and frequency of canine SO could increase while amplitude could decrease, which provide the anti-reflux function of graft SO and may serve as an obstacle to pancreatic juice flow.

Animals↗