Endoscopic manometry of the sphincter of Oddi and pancreatic duct in patients with papillary stenosis.

The function of the sphincter of Oddi (SO) in patients with papillary stenosis was evaluated using endoscopic manometry to determine its possible contribution to pancreatic dysfunction. A total of 30 patients with papillary stenosis were divided into two groups according to the pattern of narrowing of the sphincter zone observed in ERCP studies: group A, a mild form, and group B, a severe form. Group C (control) comprised 12 subjects with no abnormality of the pancreas or biliary system. The SO contraction pressure was significantly higher in group A (115.1 mmHg) than in groups B (79.2) and C (91.1). The SO basal pressure in groups A (11.5 mmHg) and B (10.3) was significantly higher than in group C (5.8). The pancreatic duct pressure in group A (15.5 mmHg) was significantly higher than in group C (9.7), while group B (11.1) showed an intermediate value. The increase in pancreatic duct pressure following intravenous secretin was significantly greater in groups A and C than in B. The BT-PABA test in groups A and C revealed a normal value in contrast to group B. A significant correlation was observed between these two factors. The function of both the SO and the pancreas thus appears to be abnormal in patients with severe narrowing of the SO and papillary stenosis.