Intraluminal pressure recording from the human sphincter of Oddi

Abstract

In this study we recorded intraluminal pressure from the human sphincter of Oddi during ERCP examination and determined the effect of enteric hormones on sphincter of Oddi motor function. Studies were obtained in 26 patients who had no demonstrable evidence of pancreaticobiliary disease. After cannulation of the common bile duct (CBD) or pancreatic duct (PD), pressure measurements were made across the sphincter of Oddi (SO) during 1-2 mm incremental withdrawals of the catheter pausing 1 min or longer at each station. The findings showed an SO segment, 4-6 mm in length, that had basal, steady-state pressure about 4 mm Hg higher than CBD or PD pressure. Pronounced phasic contractions were superimposed on the basal SO pressure. These phasic contractions measured 101 +/- 50 SE mm Hg in amplitude and 4.3 +/- 1.5 sec in duration. They had a frequency of 4.1 +/- 0.9/min. Corresponding phasic contractions were not observed in the CBD, PD, or duodenum. Intravenous pulse doses of cholecystokinin octapeptide and glucagon depressed SO motor activity, whereas pentagastrin increased SO pressure. Secretin caused a mixed response of excitation followed by inhibition. We conclude that the human sphincter of Oddi demonstrates unique phasic contractions that are altered by enteric hormones given intravenously. These phasic SO contractions may have an important role in regulating biliary and pancreatic duct employing.