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Increased sphincter of Oddi basal pressure in patients affected by gall stone disease: a role for biliary stasis and colicky pain?
  1. M Cicalaa,
  2. F I Habibb,
  3. F Fioccac,
  4. N Pallottab,
  5. E Corazziarib
  1. aGastroenterologia, Libera Università Campus Bio Medico, Roma, Italy, bCattedra di Gastroenterologia I, Dipartimento di Scienze Cliniche, Roma, Italy, cII Clinica Chirurgica, Università La Sapienza, Roma, Italy
  1. Dr M Cicala, Area di Gastroenterologia, Libera Università “Campus Bio-Medico”, Via Longoni, 83–00155 Roma, Italy. m.cicala{at}unicampus.it

Abstract

BACKGROUND AND AIMS Even if the motor activity of the gall bladder and sphincter of Oddi (SO) are integrated, it is not known if the presence of stones in the gall bladder affects SO function. The aim of the study was to compare SO motor activity in patients with and without gall stones.

PATIENTS AND METHODS In a series of 155 patients consecutively submitted to endoscopic retrograde cholangiopancreatography and SO manometry for suspected biliary or pancreatic disease, 23 gall stone patients had recurrent episodes of biliary or pancreatic pain (colicky group); 52 patients had non-biliary/pancreatic-type abdominal pain/discomfort, and of these, 15 had gall stones (non-colicky group), 25 were free of stones (controls), and 12 had undergone cholecystectomy.

RESULTS SO basal pressure in gall stone patients in the colicky or non-colicky group was significantly higher than in controls (p<0.001). SO basal pressure recorded in postcholecystectomy patients did not differ from controls. SO phasic activity did not differ between the patient groups. SO dysfunction was detected in more than 40% of gall stone patients irrespective of associated biliary/pancreatic pain but in none of the control subjects (p<0.001).

CONCLUSIONS Gall stones are frequently associated with increased SO tone which may obstruct bile flow thus acting to facilitate gall bladder stasis, and may play a role as a cofactor in biliary/pancreatic pain.

  • biliary pain
  • gall bladder
  • gall stone disease
  • sphincter of Oddi
  • Abbreviations used in this paper

    ERCP
    endoscopic retrograde cholangiopancreatography
    LFTs
    liver function tests
    SO
    sphincter of Oddi
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  • Abbreviations used in this paper

    ERCP
    endoscopic retrograde cholangiopancreatography
    LFTs
    liver function tests
    SO
    sphincter of Oddi
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