An effective method to study the pressure of the Sphincter of Oddi

The Sphincter of Oddi (SO) plays a vital role in maintaining the normal bile duct pressure, promoting gallbladder excretion and preventing from reflux. When sphincter of Oddi dysfunction (SOD) occurs, the incidence rate for bile duct infection and cholelithiasis will greatly increase. The Sphincter of Oddi Manometry (SOM) is the gold standard for examining the SOD – in which the Sphincter of Oddi pressure is well accommodated by the abundance of nerves and hormone receptors on the SO.

The research team led by Prof. Wu from General Surgery of Shengjing Hospital of China Medical University investagated the effects of H2-receptor blocking pharmacon, protease inhibitor and gastro kinetic agents on the human Sphincter of Oddi pressure measured by choledochoscope manometry, and reveals the effects of different drugs on the Sphincter of Oddi pressure. This will be published on October 14, 2008 in the World Journal of Gastroenterology.

One hundred and seventy-five patients with T tube installed after cholecystectomy and choledochotomy were assessed by choledochoscope manometry. They were randomly assigned into groups of H2-receptor blocking pharmacon, protease inhibitor, and gastro kinetic agents. The Sphincter of Oddi basal pressure (SOBP), amplitude (SOCA), frequency of contractions (SOF), duodenal pressure (DP), and common bile duct pressure (CBDP) were scored and analyzed.

They found that SOBP and SOCA were significantly decreased after Cimetidine administration, and no statistical difference was seen in the Famotidine group. In the Gabexate mesilate group, SOBP had decreased significantly. In the Ulinastatin group, SOCA decreased when Ulinastatin was given at the rate of 2500 U/min; when Ulinastatin administration was raised to 5000 U/ min, SOBP, SOF and SOCA all experienced a fall. SOBP and SOCA for Domperidone and SOCA for Mosapride groups all decreased distinctly after administration.

In conclution, they adopted simple but effective choledochoscope manometry to study the SO motility, and explored the effect of many kinds of drugs on the SO rhythm, which profited our clinical practice. Their mechanisms of action warrant further study.

Reference: Kong J, Wu SD, Zhang XB, Li ZS, Shi G, Wang W, Chen JZ. Choledochoscope manometry about different drugs on the Sphincter of Oddi. World J Gastroenterol 2008; 14(38): 5907-5912 http://www.wjgnet.com/1007-9327/14/5907.asp

Correspondence to: Shuo-Dong Wu, Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China. wushuodong@yahoo.cn Telephone: +86-24-83956291 Fax: +86-24-86368876

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

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