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Small Bowel Dysmotility in Patients with Postcholecystectomy Sphincter of Oddi Dysfunction

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Abstract

Postcholecystectomy patients (N = 27) withsevere recurrent biliary-like pain who had no evidenceof organic disease were subdivided into those with andthose without objective evidence of sphincter of Oddi dysfunction (SOD) based on two separatecriteria: (1) clinical criteria — elevated liverfunction tests and/or amylase with pain, and/or adilated bile duct, and/or delayed drainage at ERCP (N =14, SOD classes I and II); and (2) abnormal biliary manometry(N = 19). Prolonged (24–48 hr) ambulant recordingof duodenojejunal motor activity was performed in allpatients and interdigestive small bowel motor activity compared between patient subgroups and ahealthy control group. Phase II motor abnormality wasmore frequent in patients with, compared to thosewithout, objective clinical criteria of SOD (7/14 vs0/13, P = 0.003). Phase III abnormality also tendedto be more frequent in these patients (7/14 vs 2/13, P= 0.06). In addition, both phase III (P = 0.03) andphase II (P = 0.03) motility index (MI) was higher inpatients with sphincter dyskinesia compared to controls;phase II MI was also higher in patients with sphincterstenosis (P = 0.005). Disturbances of small bowelinterdigestive motor activity are more prevalent in postcholecystectomy patients with, compared tothose without, objective evidence of SOD, and especiallyin patients with SO dyskinesia. Postcholecystectomy SODin some patients may thus represent a component of a more generalized intestinal motordisorder.

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Authors
  1. Peter R. Evans
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  2. Young-Tae Bak
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  3. John F. Dowsett
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  4. Ross C. Smith
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  5. John E. Kellow
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Evans, P.R., Bak, YT., Dowsett, J.F. et al. Small Bowel Dysmotility in Patients with Postcholecystectomy Sphincter of Oddi Dysfunction. Dig Dis Sci 42, 1507–1512 (1997). https://doi.org/10.1023/A:1018879029855

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  • DOI: https://doi.org/10.1023/A:1018879029855

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