The orifice of duodenal papilla is only about l mm in diameter. As much as 2,ooo ml of bile and pancreatic juice pass through its sphincter zone into the duodenum each day. Since the sphincter can disturb the smooth outflow of bile and produce
secondary
abnormalities in the biliary tract or the exocrine pancreas.
Recently, pressure dynamics of the sphincter of Oddi have been reported in various pancreatobiliary diseases, but the physiology and pathophysiology of the sphincter of Oddi and pancreatic ductal pressure have been poorly investigated in patients
with
chronic pancreatitis.
The present study was undertaken to compare the sphincter of Oddi and pancreatic duct pressures in 7 patients with chronic pancreatitis and in 8 normal controls and to determine whether pressure differences exist in patients subdivided by the
findings
of endoscopic retrograde pancreatograms (ERP)
@ES The following results were obtained:
@EN 1) The basal pressure of phasic contractions of pancreatic duct sphincter in patients with chronic pancreatitis(18.8±16.0 mmHg ) was ssignificantly higher than that in normal controls(5.4±2.3 mmHg). There were no statistically significant
differences in main pancreatic duct pressure, and peak pressure, frequency, duration and direction of propagation of phasic contractions of pancreatic duct sphincter between the patients with chronic pancreatitis and normal controls.
2) When the patients with chronic pancreatitis were subdivided into 3 groups according to ERP findings, the pressure of main pancreatic duct and basal pressure of phasic contractions of pancreatic duct sphincter in group B(focally abnormal side
branches in pancreas tail) were remarkably higher than those of group A(segmental stenosis at pancreatic head with poststenotic dilatation) and group C(diffuse abnormalities in entire pancreatic duct).
In conclusion, the abnormalities of motility in pancreatic duct sphincter and the different manometric findings among each group subdivided by ERP findings in patients with chronic pancreatitis may suggest the important role of motility of
pancreatic
duct sphincter jn the pathogenesis of chronic pancreatitis, however further studies in more cases will be required.
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