Study So Manometry And So Changes Of Shape Its Relatationship With Bile Duct Stones

ObjectiveTo study the sphincter of Oddi(SO) manometry and to observe SO changes of shape via choledochofiberscope through"T"tube tract for 120 patients post-biliary exploration. to evaluate its relatationship with bile duct stones.Methodsone hundred and twenty patients who had a T tube after operations were assessed by choledochoscopic manometry.SO basal pressure(SOBP),amplitude of SO contractions(SOCA),frequncy of SO contractions(SOCF),duration of SO contractions(SOCD),duodenal pressure(DP),common bile duct pressure(CBDP),and the percentage of propagate directions were scored analyzed. According choledochoscopic results will be SO open dots form into regular dot shape, narrow dot shape, radial shape, irregular, fish- mouth shape, The patients were divided into three groups according to the levels of sphincter of Oddi basal pressure: sphincter of Oddi hypomotility,normal SO movement,sphincter of Oddi hypermotility.Resultsthere were 36 patients in group A.the mean of SOBP was 4.07 mmHg(30%), SO was irregular shape or fish-mouth shape. there were 71 patients in the B groups. the mean of SOBP was 18.56 mmHg(59%), SO was regular dot shape or radial shape. there were 13 patients in group C. the mean of SOBP was 50.25 mmHg(11%), SO was narrow dot shape. SOBP,SOCA, DP in group A were much lower than B and C group(P<0.05), the mean COBD in group B had no significant difference from that in group C;but SOBD and SOCA in group B were lower than that in group C(P<0.05);SOF in group A(fish-mouth shape) was much lower than that in the other groups(P<0.05).but every group was not statistically different in the percentage of synchronous peristalsis,retrograte peristalsis and comliant peristalsis(P>0.05).ConclusionsAccording choledochoscopic results will be divided SO form into regular dot shape, narrow dot shape, radial shape, irregular shape, fish- mouth shape, SO Functional and morphological abnormalities can cause changes in biliary pressure and power ,SO hypomotility , hypermotility and normal exist in bile duct stone patients after operation,which can be diagnosed effectively by choledochoscopic manometry, SO was narrow dot shape. SOBP is increased, which may cause the Bile duct stones ;SO was irregular or fish-mouth shape, SOBP is decreased, duodenal-biliary reflux, and high rate of bacterial culture was positive,it may be associated with the recurrence of bile duct stone and cholangitis.