Document Detail

Biliary motility following endoscopic sphincterotomy for recurrent common bile duct stones.
MedLine Citation:
PMID:  8854437     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recurrent common bile duct (CBD) stones after cholecystectomy are a common biliary tract disease. The role of biliary emptying in the formation of these stones is not yet well defined. METHODS: Cholescintigraphy was used to evaluate the biliary motility in 50 cholecystectomized patients with recurrent CBD stones after endoscopic sphincterotomy (EST) with stone extraction. Complete clearance of the CBD stones was confirmed in all patients by endoscopic retrograde cholangiopancreatography. Absence of sphincter of Oddi (SO) pressure after EST was determined by means of biliary manometry, and 99mTc-diisopropyl iminodiacetic acid (DISIDA) cholescintigraphy was performed four to six weeks after recovery from sphincterotomy. RESULTS: Complete clearance of the radioisotopes from the bile duct within 1, and more than 1 hour, was observed in 3 (6%) and 47 (94%) of the patients, respectively. When a cutoff value of 2 hours indicating abnormal biliary motility was employed, 31 out of the 50 patients (62%) had delayed biliary emptying. In comparing the clinical parameters between the two groups, patients with delayed biliary emptying time demonstrated an increase in CBD size greater than those of the normals (11.7 +/- 0.5 vs 9.2 +/- 0.4 mm, p < 0.05), while the presence of juxtapapillary diverticula and length of time for recurrence of CBD stones after cholecystectomy were not significant. Follow-up study showed that repeated recurrence rate of CBD stones appeared to be higher in the patients associated with delayed (12.9%) rather than normal (5.3%) biliary emptying. CONCLUSIONS: These results suggested that, in the absence of a functioning SO, abnormal biliary motility in cholecystectomized patients is one of the clinical factors involved in the pathogenesis of recurrent CBD stones.
W W Ng; K H Lai; R S Liu; T N Tam; J S Cheng; S D Lee
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Zhonghua yi xue za zhi = Chinese medical journal; Free China ed     Volume:  56     ISSN:  0578-1337     ISO Abbreviation:  Zhonghua Yi Xue Za Zhi (Taipei)     Publication Date:  1995 Sep 
Date Detail:
Created Date:  1996-11-07     Completed Date:  1996-11-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0005327     Medline TA:  Zhonghua Yi Xue Za Zhi (Taipei)     Country:  TAIWAN    
Other Details:
Languages:  eng     Pagination:  159-65     Citation Subset:  IM    
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.
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MeSH Terms
Bile Ducts / physiopathology*
Gallstones / physiopathology,  surgery*
Middle Aged
Sphincterotomy, Endoscopic*

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