Reflux through the Sphincter of Oddi? Influence of Duodenal Distention upon Biliary Tract and Pancreas

2015 ◽  
pp. 86-89
Author(s):  
J. E. Murat
Keyword(s):  
Biliary Tract ◽  
Sphincter Of Oddi

The Sphincter of Oddi is a Boundary for Bacterial Colonisation in the Feline Biliary Tract

1990 ◽  
Vol 3 (4) ◽  
Author(s):  
J. Y. Sung ◽  
M. E. Olson ◽  
J. W. C. Leung ◽  
M. S. Lundberg ◽  
J. W. Costerton
Keyword(s):  
Biliary Tract ◽  
Sphincter Of Oddi ◽  
Bacterial Colonisation

Biliary tract dysmotility and sphincter of Oddi dyskinesia

1997 ◽  
Vol 50 (4) ◽  
pp. 174-179
Author(s):  
G VANBERGEHENEGOUWEN ◽  
M SAMSON ◽  
A SMOUT
Keyword(s):  
Biliary Tract ◽  
Sphincter Of Oddi

Incidence and risk factors for cholangitis during systemic chemotherapy among patients with advanced biliary tract cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 313-313 ◽  
Author(s):  
J. Hashimoto ◽  
C. Morizane ◽  
S. Kondo ◽  
H. Ueno ◽  
S. Mitsunaga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Median Time ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Biliary Drainage ◽  
Systemic Chemotherapy ◽  
Sphincter Of Oddi ◽  
Ampullary Cancer ◽  
First Episode ◽  
Tract Cancer

313 Background: Patients with biliary tract cancer (BTC) have a high risk of developing cholangitis. In patients with advanced BTC receiving systemic chemotherapy, cholangitis might interfere with the execution of the treatment. Furthermore, cholangitis during severe immunosuppression might develop into lethal complications such as sepsis or shock. Purpose: To determine the incidence of cholangitis among patients with advanced BTC undergoing systemic chemotherapy and to identify risk factors for the development of cholangitis. Methods: We reviewed the records of 301 patients with advanced BTC who received systemic chemotherapy at our hospital between February 2002 and July 2009. The clinical data of patients treated with gemcitabine monotherapy (GEM) as a first-line chemotherapy was retrieved. Results: One hundred and thirty-one patients were successfully followed up throughout the entire GEM treatment. Forty-three patients had intrahepatic BTC (32.8%), 28 had extrahepatic BTC (21.4%), 11 had hilar BTC (8.4%), 7 had ampullary cancer (5.3%), and 42 had gallbladder cancer (32.1%). Interventional radiological treatment or biliary reconstruction for biliary obstruction was performed in 50 patients (37.9%) prior to the start of chemotherapy. The median time to GEM treatment failure was 126 days. Cholangitis developed in 30 patients (22.9%) during GEM, and severe cholangitis developed in 10 patients (7.6%). The median time to the first episode of cholangitis from the start of chemotherapy was 65 days. Chemotherapy was discontinued because of cholangitis in 4 patients (3.1%), but no deaths as a result of cholangitis occurred. A multivariate analysis using a logistic regression model demonstrated that the presence of hilar obstruction (p=0.0002, OR: 10.748), the loss of sphincter of Oddi function (p=0.0005,OR: 8.960), and the presence of internal biliary drainage (p=0.007, OR: 4.472) were independent risk factors of cholangitis. Conclusions: The incidence of cholangitis during GEM treatment was 22.9% among the advanced BTC patients in this study. Hilar obstruction, the loss of sphincter of Oddi function, and internal biliary drainage may be risk factors of cholangitis. No significant financial relationships to disclose.

scholarly journals Physiology and Pathophysiology of the Biliary Tract: The Gallbladder and Sphincter of Oddi—A Review

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Jose Behar
Keyword(s):  
Biliary Tract ◽  
Bile Salts ◽  
Standard Treatment ◽  
Sphincter Of Oddi ◽  
Chronic Cholecystitis ◽  
Gallbladder Motility ◽  
Hepatic Bile ◽  
Biliary Pain ◽  
Pain Affect ◽  
Upper Abdominal

The biliary tract collects, stores, concentrates, and delivers bile secreted by the liver. Its motility is controlled by neurohormonal mechanisms with the vagus and splanchnic nerves and the hormone cholecystokinin playing key roles. These neurohormonal mechanisms integrate the motility of the gallbladder and sphincter of Oddi (SO) with the gastrointestinal tract in the fasting and digestive phases. During fasting most of the hepatic bile is diverted toward the gallbladder by the resistance of the SO. The gallbladder allows the gradual entry of bile relaxing by passive and active mechanisms. During the digestive phase the gallbladder contracts, and the SO relaxes allowing bile to be released into the duodenum for the digestion and absorption of fats. Pathological processes manifested by recurrent episodes of upper abdominal pain affect both the gallbladder and SO. The gallbladder motility and cytoprotective functions are impaired by lithogenic hepatic bile with excess cholesterol allowing the hydrophobic bile salts to induce chronic cholecystitis. Laparoscopic cholecystectomy is the standard treatment. Three types of SO dyskinesia also cause biliary pain. Their pathophysiology is not completely known. The pain of types I and II usually respond to sphincterotomy, but the pain due to type III usually does not.

scholarly journals Trimebutine maleate in the treatment of functional biliary disorders: TRIBUNE study results

2019 ◽  
pp. 117-125
Author(s):  
V. T. Ivashkin ◽  
Ch. S. Pavlov ◽  
I. R. Popova ◽  
Yu. O. Shulpekova
Keyword(s):  
Gall Bladder ◽  
Biliary Tract ◽  
Bile Ducts ◽  
Sphincter Of Oddi ◽  
Functional Disorders ◽  
Biliary Pain ◽  
Standard Dosage ◽  
Trimebutine Maleate ◽  
Study Results ◽  
Rome Iv

Introduction. The term «functional disorders of the biliary tract and bile ducts» defines the conditions, which produce typical patterns of biliary pains in the absence of obvious signs of organic lesions of the gallbladder and bile ducts. The materials of the Rome IV consensus present the diagnostic criteria of their main types – functional disorders of the gall bladder and sphincter of Oddi. Vasilenko Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology of the University Clinical Hospital No. 2 of Sechenov University carried out a noninterventional observational program to study the experience in using Trimedat® (trimebutine maleate) in the routine outpatient and inpatient practice in the treatment of patients with functional diseases of the biliary tract. Information partners of the program are the Russian Gastroenterological Association (RGA) and the Russian Society for the Study of the Liver (RSSL).Materials and methods. The program included patients of both sexes aged 18 to 65 years with ICD-10 diagnoses «spasm of the sphincter of Oddi» (K 83.4), «postcholecystectomy syndrome» (K 91.5), «other specified diseases of the gallbladder» (K 82.8) , «other specified diseases of the bile ducts» (K 83.8), «disorders of gallbladder and biliary tract in diseases classified elsewhere» (K 87.0), if the clinical picture was consistent with functional biliary disorders according to the Rome IV criteria and in cases when the doctor decided to prescribe Trimedat® therapy. Patients were observed for 28 ± 1 days. The dynamics of biliary pain and discomfort, as well as other symptoms (in particular, nausea, flatulence) were evaluated on the background of the therapy, using the Gastrointestinal Symptom Score Scale, in which the severity of each symptom is estimated by 7 grades (Alekseev N.Yu., 2006) with adding a section to evaluate the biliary disorders. In the presence of criteria for functional disorders of the gallbladder, an ultrasound control of the fraction of its discharge was carried out before and after the therapy.Results. 100 patients (33 (33%) men and 67 (67%) women, the average age 42.2 ± 13.2 years (18–65 years)) were enrolled in the program. In accordance with the Rome IV Consensus, the majority of patients (83 (83%)) had the functional disorders of GB; in 16 (16%) patients with the removed GB, the picture corresponded to the functional disorder of SO, one patient with kept GB was diagnosed with SO dysfunction. The treatment with Trimedate® at a standard dosage resulted in a decrease in the proportion of pain in the epigastric region (in the Scale section evaluating the biliary tract symptoms), the degree of nausea and bloating. Differences between the visits were estimated by the Friedman’s test, p <0.001. In addition, other sections of the scale also showed a decrease in indicators in scores. 79 patients underwent repeated ultrasound cholecystography at the end of treatment. It showed an increase in the fraction of GB emptying.Conclusions. The use of Trimedate® in patients with functional disorders of the gall bladder and sphincter of Oddi resulted in the reduction of the severity of the main symptoms - the severity of biliary pain, nausea, bloating. The patients with GB dysfunction showed an increase in the fraction of GB emptying.

Gender influences sphincter of Oddi response to cholecystokinin in the prairie dog

1995 ◽  
Vol 269 (4) ◽  
pp. G476-G480 ◽  
Author(s):  
S. Tierney ◽  
Z. Qian ◽  
B. Yung ◽  
P. A. Lipsett ◽  
H. A. Pitt ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Biliary Tract ◽  
Biliary Tract Disease ◽  
Sphincter Of Oddi ◽  
Prairie Dogs ◽  
Gallbladder Emptying ◽  
Motility Index ◽  
Sphincter Of Oddi Motility ◽  
Tract Disease ◽  
Alpha Chloralose

Although gallstones and disorders of biliary tract motility are both more common in women than men, sphincter of Oddi motility has not previously been compared between the sexes. In this study, cholescintigraphy (under ketamine and diazepam anesthesia) was used to determine gallbladder emptying rate and ejection fraction in response to cholecystokinin (CCK) in eight male and six female prairie dogs fed a nonlithogenic diet. Ten days later, under alpha-chloralose anesthesia, sphincter of Oddi phasic wave activity was monitored for 10-min intervals before (control), during 20 min of CCK infusion, and for 20 min after infusion. Gallbladder emptying rate and ejection fraction and baseline sphincter of Oddi frequency, amplitude, and motility index (= frequency x amplitude) did not differ significantly between the sexes. Sphincter of Oddi phasic wave frequency was increased during CCK infusion in both males and females, but the change in amplitude was significantly greater in females, than males. We conclude that the increased incidence of biliary tract disease in women may be due to altered sphincter of Oddi hormonal response.

Balloon Dilatation of the Sphincter of Oddi Facilitates Passage of Glass Beads from the Canine Biliary Tract

1994 ◽  
Vol 4 (6) ◽  
pp. 413-417 ◽  
Author(s):  
THEODORE N. PAPPAS ◽  
MARY POWERS ◽  
MARCIA R. GOTTFRIED ◽  
PETER B. COTTON
Keyword(s):  
Biliary Tract ◽  
Balloon Dilatation ◽  
Sphincter Of Oddi ◽  
Glass Beads
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