Skip to main content
NCBI home page
Gut logoLink to Gut
. 1988 Oct;29(10):1397–1401. doi: 10.1136/gut.29.10.1397

Quantitative 99mTc-DISIDA scanning and endoscopic biliary manometry in sphincter of Oddi dysfunction.

G M Fullarton 1, A Allan 1, T Hilditch 1, W R Murray 1
PMCID: PMC1433998  PMID: 3197984

Abstract

Sphincter of Oddi (SO) dysfunction is a recognised cause of postcholecystectomy pain, but a difficult condition to diagnose, requiring endoscopic biliary manometry (EBM) to confirm sphincter motor abnormalities. We have assessed quantitative cholescintigraphy in 10 postcholecystectomy (PC) patients with clinical and manometric evidence of SO dysfunction, 10 PC patients with non-biliary type abdominal pain and 10 asymptomatic PC volunteers acting as controls to determine its value as a non-invasive screening test. Quantitative 99mTc-DISIDA scans lasted 60 minutes, activity/time curves being created by computer analysis using the entire hepatobiliary system as region-of-interest (ROI). Scintigraphic analysis demonstrated that the time in minutes to maximum counts (Tmax) was significantly increased in the SO dysfunction group compared with the non-biliary pain group and the asymptomatic volunteers (p less than 0.001). The per cent of biliary tracer emptied was also significantly less in the SO dysfunction group than either of the other groups at both 45 minutes (p less than 0.01) and 60 minutes (p less than 0.02). We conclude that quantitative cholescintigraphy may be a valuable non-invasive screening test in clinically suspected SO dysfunction.

Full text

PDF
1397

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arndorfer R. C., Stef J. J., Dodds W. J., Linehan J. H., Hogan W. J. Improved infusion system for intraluminal esophageal manometry. Gastroenterology. 1977 Jul;73(1):23–27. [PubMed] [Google Scholar]
  2. Bar-Meir S., Geenen J. E., Hogan W. J., Dodds W. J., Stewart E. T., Arndorfer R. C. Biliary and pancreatic duct pressures measured by ERCP manometry in patients with suspected papillary stenosis. Dig Dis Sci. 1979 Mar;24(3):209–213. doi: 10.1007/BF01308431. [DOI] [PubMed] [Google Scholar]
  3. Bar-Meir S., Halpern Z., Bardan E., Gilat T. Frequency of papillary dysfunction among cholecystectomized patients. Hepatology. 1984 Mar-Apr;4(2):328–330. doi: 10.1002/hep.1840040225. [DOI] [PubMed] [Google Scholar]
  4. Bortolotti M., Caletti G. C., Brocchi E., Bersani G., Caletti T., Guizzardi G., Labò G. Endoscopic manometry in the diagnosis of the postcholecystectomy pain syndrome. Digestion. 1983;28(3):153–157. doi: 10.1159/000198979. [DOI] [PubMed] [Google Scholar]
  5. Carr-Locke D. L., Gregg J. A. Endoscopic manometry of pancreatic and biliary sphincter zones in man. Basal results in healthy volunteers. Dig Dis Sci. 1981 Jan;26(1):7–15. doi: 10.1007/BF01307970. [DOI] [PubMed] [Google Scholar]
  6. De Masi E., Corazziari E., Habib F. I., Fontana B., Gatti V., Fegiz G. F., Torsoli A. Manometric study of the sphincter of Oddi in patients with and without common bile duct stones. Gut. 1984 Mar;25(3):275–278. doi: 10.1136/gut.25.3.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Funch-Jensen P., Kruse A., Ravnsbaek J. Endoscopic sphincter of Oddi manometry in healthy volunteers. Scand J Gastroenterol. 1987 Mar;22(2):243–249. doi: 10.3109/00365528708991887. [DOI] [PubMed] [Google Scholar]
  8. Lebovics E., Heier S. K., Rosenthal W. S. Sphincter of Oddi motility: developments in physiology and clinical application. Am J Gastroenterol. 1986 Sep;81(9):736–743. [PubMed] [Google Scholar]
  9. Meshkinpour H., Mollot M., Eckerling G. B., Bookman L. Bile duct dyskinesia. Clinical and manometric study. Gastroenterology. 1984 Oct;87(4):759–762. [PubMed] [Google Scholar]
  10. Nardi G. L., Acosta J. M. Papillitis as a cause of pancreatitis and abdominal pain: role of evocative test, operative pancreatography and histologic evaluation. Ann Surg. 1966 Oct;164(4):611–621. doi: 10.1097/00000658-196610000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. RYAN J. D., DOUBILET H., MULHOLLAND J. H. Observations of biliary-pancreatic dynamics in a normal human. Gastroenterology. 1949 Jul;13(1):1–8. [PubMed] [Google Scholar]
  12. Shaffer E. A., Hershfield N. B., Logan K., Kloiber R. Cholescintigraphic detection of functional obstruction of the sphincter of Oddi. Effect of papillotomy. Gastroenterology. 1986 Mar;90(3):728–733. doi: 10.1016/0016-5085(86)91130-3. [DOI] [PubMed] [Google Scholar]
  13. Toouli J., Geenen J. E., Hogan W. J., Dodds W. J., Arndorfer R. C. Sphincter of Oddi motor activity: a comparison between patients with common bile duct stones and controls. Gastroenterology. 1982 Jan;82(1):111–117. [PubMed] [Google Scholar]
  14. Toouli J., Roberts-Thomson I. C., Dent J., Lee J. Manometric disorders in patients with suspected sphincter of Oddi dysfunction. Gastroenterology. 1985 May;88(5 Pt 1):1243–1250. doi: 10.1016/s0016-5085(85)80086-x. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES