Biliary motility disorders.

Disordered motility of the biliary tract may be associated with the aetiology of common biliary tract conditions, such as gallstones. In this instance, treatment of the gallstone disease alleviates symptoms in the majority of patients. However, in up to 10% of patients, biliary motility disorders may present in the absence of gallstones or in patients after cholecystectomy. Gallbladder dyskinesia results in biliary-type pain. This abnormality may be objectively identified using the radionuclide gallbladder ejection fraction. The majority of patients with an abnormal test are improved or cured following cholecystectomy. Sphincter of Oddi dysfunction presents with either recurrent biliary-type pain or recurrent pancreatitis. Manometry of the sphincter of Oddi objectively identifies patients with manometric stenosis. The majority of these patients are improved or cured following division of the sphincter of Oddi.