Endoscopic manometry of pancreatic and biliary sphincter zones in man

• DOI: 10.1007/bf01307970
• Publication Date: 2005-04-11T21:14:54Z
• Authors: David L. Carr-Locke; James A. Gregg
• Keywords: Adult; Male; Diazepam; Duodenum; Manometry; Pancreatic Ducts; Contrast Media; Endoscopy; Catheterization; 03 medical and health sciences; 0302 clinical medicine; Pressure; Humans; Female; Sphincter of Oddi; Gastrointestinal Motility

An endoscopic manometric technique was applied to the study of intraductal biliary and pancreatic pressures and sphincter activity in normal subjects. A perfused system using a modified endoscopic retrograde cholangiopancreatography catheter was tested and found to provide reliable ductal and phasic recordings. Twenty-five healthy volunteers, aged 19-37, underwent endoscopic manometry under diazepam sedation. Distinct zones of high-pressure phasic activity were identified on pull-through from the pancreatic duct and common bile duct at mean distances of 4.5 and 5.0 mm, respectively, from the papillary orifice with frequencies of 7.0 +/- 1.8 (mean +/- SD) and 5.6 +/- 2.4 waves/min, respectively. These were considered to represent separate pancreatic duct and bile duct sphincters. Peak pancreatic duct sphincter pressure (47.6 +/- 8.2 mm Hg) and bile duct sphincter pressure (57.2 +/- 10.7 mm Hg) were similar. Pancreatic duct pressure was 11.4 +/- 3.0 mm Hg and common bile duct pressure was 3.0 +/- 2.5 mm Hg. Values were adjusted to duodenal pressure as zero reference. The ductal and sphincteric pressures reported in this study provide a basis for the assessment of physiological, pharmacological, pathophysiological, and surgical effects on this area.