J.Jpn. Surg. Soc.. 82(12): 1468-1484, 1981

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Original article

STUDIES ON FUNCTION OF THE TERMINAL MUSCLE OF COMMON BILE DUCT

In order to clarify the mode of motion of terminal muscle of common bile duct, and its role in the bile flow mechanism, cases whose terminal muscle of common bile duct had neither abnormal initial intraductal pressure nor change to any morbid state, were selected and intraductal pressure was measured. A multipolar pressure sensor, which could convert the concentric contractions of the terminal muscle of common bile duce at several points into convex waveforms on a polygraph, was devised and these waveforms (electromyokinetogram) and the electromyogram of terminal muscle of common bile duct of a rabbit prepared by a special multipolar needle electrode were also analysed.
When pentazocine, morphine and meperidine were administered, the whole terminal muscle of common bile duct showed continual contractions with almost no lag of action potential recognized from hepatic side to duodenal side; flow of bile into the duodenum stopped and the biliary intraductal pressure increased remarkably.
The terminal muscle of common bile duct of humans, when an anti-cholinergic agent such as hyoscine butylbromide was administered, stopped motion and relaxed, and a slight biliary stasis due to natural tonus at the end of terminal muscle of common bile duct was observed.
When metoclopramide was administered, the electromyogram of terminal muscle of a rabbit showed the activated action potential and some lag of said action potential from hepatic side to duodenal side, while analysis of the electromyokinetogram of humans also revealed the increased action waveform and a similar lag of the action potential; the flow of bile into the duodenum increased and the biliary intraductal pressure lowered sligthly.
It has been suggested that the terminal muscle of common bile duct of humans does not show the motion as a sphincter muscle but as a peristaltic muscle under the conditions of cholecystectomised state and low-flow perfusion, and that bile is discharged into the duodenum by the contratile motion of the terminal muscle of common bile duct.

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