Normal and abnormal motor function of human sphincter of Oddi

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An evaluation of the motility of the sphincter of Oddi (SO) is important to diagnose whether a pathologic condition at the choledochoduodenal junction is of a functional or organic variety. For a basic knowledge about the motor function of the SO, we conducted a clinical research works.1) Manometric apparatus and Measurement of Motor Function of the Sphincter of Oddi: We developed a simple and easy-for-use infusion system that consisted of a ordinary i.v. pump connected with a high resistance check valve for arterial manometry (Intralfo). The performance of the system in the SO manometry was comparable to hydraulic-capillary infusion system or pressure catheter transducer. The infusion catheter was best settled via PTCD route. This method made a harmless long-lasting manometric study possible.2) CCK Administration and Motility of the Sphincter of Oddi: An intravenous dosage of 0.2-0.3 U/Kg/min of CCK-33for 10 min enhanced the plasma CCK level up to 30-50 pg/ml (control: below 7.5). at … More 8 to 10 min after the commencement of the intravenous CCK-33. The SO motor activities, both contractile force and frequency, were markedly suppressed to as low as 10-0 % of the control values. The suppression lasted for nearly 15 min. While, the gallbladder (GB) contracted strongly with a maximal contraction at 15-20 min after the beginning of CCK-33. It was concluded that reciprocal responses of the SO and GB to CCK yield and effective driving force for bile discharge.3) Motility of the Sphincter of Oddi during Interdigestive State: The SO motor activity was simultaneously registered with that of the duodenum. Although not consistently observed, the SO contracted 3-4/min even in the period of duodenal phase I, showing that the SO motor activity may be, fundamentally, independent of that of the duodenum. During duodenal phase II and II, the SO contractions were temporarily highly linked to the duodenal contractions with a frequency of 10-12/min. We concluded that fasting state, digestive or interdigestive, must be clearly documented when we refer to or evaluate the motor function of the SO and that a simultaneous recording of the duodenal motor activity is mandatory when we determine the SO motor function. Less