J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 2431KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 87(9): 1064-1068, 1986

Report on the annual meeting

NEW METHOD OF BILIARY MANOMETRY BY ACCELERATING PERFUSION FLOW RATE

1) Second Dep. of Surgery, Juntendo University School of Medicine, Tokyo, Japan
2) Second Dep. Of Surgery, University of Tokyo, Tokyo, Japan
3) Faculty of Medicine, University of Tokyo, Tokyo, Japan

Tomoe Beppu1), Minoru Saito1), Mitsuo Sugiura1), Kazuo Shibayama2), Yasuo Idezuki2), Kazuhiko Ohe3), Yuzo Onogi3)

A new method of intraoperative biliary manometry is presented. In this method, saline flow is controlled over a range from 0 to 0.5ml/sec and the biliary pressure is measured continously and displayed as a two-dimensional pressure-flow curve. The raised pressure caused by the cannula inserted into the bile duct is subtracted in real time by a computer which yields the actual intrabiliary pressure. The pressure increase from resting pressure (⊿P) is the value expressing the resistance against flow into the duodenum. The elasticity of the papilla of Vater is reflected from the curve bending.
New manometry was applied to 85 cases of biliary tract disease. In 68 cases of gallbladder stone, ⊿P is below 20cm saline at 0.5ml/sec. In nearly all choledochal stones, curve is fluctuated reflecting the hindrance of the flow. In 6 cases of primary biliary stone, ⊿P is rather low reflecting the incompetent papilla. After morphine injection, resting pressure and ⊿P is increased. In some clinical cases, this contraction of the sphincter was observed. In mongrel dogs, this contraction was facilitated by neostigmine methylsulfate, and was suppressed by scoporamine butylbromide and also by truncal vagotomy. New manometry developed by authors is sensitive to detect biliary disorders, particularly outflow hindrance.

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