Effects of sphincter of Oddi motility on the formation of cholesterol gallstones

Rong, Zhonghou; Chen, Hong‐Yuan; Wang, Xinxing; Wang, Zhiyi; Xian, Guozhe; Ma, Bang-Zhen; Qin, Chengkun; Zhang, Zhenhai

doi:10.3748/wjg.v22.i24.5540

Cited by 9 publications

(8 citation statements)

References 25 publications

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“…For SO phasic contraction, amplitude, peak and period, EEPP showed similar pattern with basal and CBD pressure. The decreasing SO myoelectric activity including amplitude and frequency was related to the formation of gallstone 13 . Moreover, SO contraction frequency even further increased in some animals, may reduced the risk of EST complications, such as recurrent choledocholithiasis, but this need to be further identified.…”

Section: Discussionmentioning

confidence: 97%

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Endoscopic endoclip papilloplasty preserves sphincter of oddi function

Wang

Chang

Zhang

et al. 2020

Eur J Clin Investigation

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Background Endoscopic sphincterotomy (EST) can destroy sphincter of Oddi (SO) structure and function. The purpose of this study was to assess the feasibility of endoscopic endoclip papilloplasty (EEPP) in restoring SO function after EST. Methods Seven 26‐week‐old domestic pigs were divided into control and EEPP groups. Necropsy and haematoxylin‐eosin staining plus anti‐α‐smooth muscle actin (α‐SMA) staining of papilla and sphincter of Oddi manometry (SOM) were conducted in animals at three independent time points. Results EST and EEPP were safely performed in all 7 pigs without serious adverse events. For primary outcome, compared to the controls, EEPP generated smaller dilation and less inflammation. Fibrous repair of the papilla was observed at 24 weeks after EEPP. For secondary outcome, in the control group, SO basal pressure (17.25 ± 18.14 to 5.50 ± 0.71 mmHg), SO contraction amplitude (46.00 ± 19.20 to 34.50 ± 48.79 mmHg), peak (4.50 ± 4.04 to 1.50 ± 2.12) and frequency (3.05 ± 3.29 to 1.41 ± 2.19/min) were reduced after EST. Further reductions to almost 0 of these SOM parameters were observed 3 weeks later, including common bile duct pressure and SO contraction period. In contrast, in the EEPP group, these manometric data were recovered to pre‐EST levels, including CBD pressure (11.5 ± 7.31 vs 11 ± 2.16 mmHg), SO pressure (17.50 ± 17.75 vs 18.20 ± 21.39 mmHg) and SO contraction amplitude (53.67 ± 21.54 vs 60.00 ± 36.08 mmHg). However, no significant differences were observed between control and EEPP groups by Student t test. Conclusions In this porcine study, EEPP accelerated and improved papillary healing after EST, further preserved SO function.

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Section: Discussionmentioning

confidence: 97%

“…The choledochoduodenal pressure gradient and SO basal pressure were totally lost 15‐17 years after EST, following with duodenobiliary reflux 12 . The SO hypoactivity in terms of frequency and amplitude relates to gallstone formation 13 . In managing large CBD stones (>1 cm diameter), generous EST (>1 cm) usually was performed.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic endoclip papilloplasty preserves sphincter of oddi function

Wang

Chang

Zhang

et al. 2020

Eur J Clin Investigation

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“…In the present study, hypercholesterolemia was successfully induced, and elevated levels of T-CHOL in the bile from guinea pigs were observed when fed a LD for 2 or 8 weeks. Several studies have shown that a LD facilitates the formation of cholesterol gallstones in guinea pigs ( 21 , 22 ). Hence, in the present study, LD-fed guinea pigs were used to investigate the possible mechanisms underlying gallbladder hypomotility in the development of cholesterol cholelithiasis.…”

Section: Discussionmentioning

confidence: 99%

Changes in the interstitial cells of Cajal in the gallbladder of guinea pigs fed a lithogenic diet

Huang

Ding

2021

Exp Ther Med

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Cholesterol cholelithiasis is a common disease and gallbladder hypomotility may underlie its pathogenesis. Interstitial cells of Cajal (ICCs) in the gallbladder serve vital roles in regulating gallbladder motility. The aim of the present study was to investigate changes in gallbladder ICCs during the development of cholesterol cholelithiasis. A total of 40 male guinea pigs were randomly assigned to four groups and fed a standard diet (SD) or lithogenic diet (LD) for 2 or 8 weeks. The LD significantly increased the total cholesterol levels in the serum and bile, as well as the serum levels of high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol after 2 and 8 weeks. The LD also significantly increased and decreased the number of gallbladder ICCs at 2 and 8 weeks, respectively, by regulating the stem cell factor/C-kit pathway. Moreover, the ultrastructure of gallbladder ICCs was significantly altered after 8 weeks, and the protein expression levels of connexin 43 in the gallbladder were differentially altered after 2 and 8 weeks. Finally, cholecystokinin receptor type A (CCK1R) expression in the gallbladder was assessed. In gallbladder ICCs, its expression was significantly increased and decreased after 2 and 8 weeks, respectively. In conclusion, these results demonstrate that the density, ultrastructure and CCK1R expression levels of gallbladder ICCs are differentially altered at various stages of cholesterol cholelithiasis progression, indicating that gallbladder ICCs may be considered a potential therapeutic target for treatment of cholesterol cholelithiasis.

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“…The choledochoduodenal pressure gradient and SO basal pressure were totally lost 15 to 17 years after EST, following with duodenobiliary reflux [12]. The SO hypoactivity in terms of frequency and amplitude relates to gallstone formation [13]. In managing large CBD stones (> 1cm diameter), generous EST (> 1cm) usually was performed.…”

Section: Discussionmentioning

confidence: 99%

“…For SO phasic contraction, amplitude, peak and period showed similar pattern with basal and CBD pressure. The decreasing SO myoelectric activity such as amplitude and frequency is related to the formation of gallstone formation [13]. Since EEPP restores SO contraction, EEPP may reduce the risk of recurrent choledocholithiasis.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Endoclip Papilloplasty Preserves Sphincter of Oddi Function After Endoscopic Sphincterotomy in Porcine Models

Wang

Chang

Zhang

et al. 2020

Preprint

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Background Endoscopic sphincterotomy (EST) can destroy sphincter of Oddi (SO) function and plays a role in recurrent choledocholithiasis and cholangitis development. The purpose of this study was to assess the feasibility of endoscopic endoclip papilloplasty (EEPP) in restoring SO function after EST. Methods Seven 26-week-old domestic pigs were divided into control and EEPP groups. Necropsy, hematoxylin-eosin staining, anti-α-smooth muscle actin (α-SMA) staining of papilla and sphincter of Oddi manometry (SOM) were conducted in animals at three independent time points. Results EST and EEPP were safely performed in all 7 pigs without serious adverse events. For primary outcome, compared to the controls, EEPP generated smaller dilation with less inflammation. Fibrous repair of the papilla was observed at 24 weeks after EEPP. For secondary outcome, in the control group, SO basal pressure (17.25 ± 18.14 to 5.50 ± 0.71 mmHg), SO contraction amplitude (46.00 ± 19.20 to 34.50 ± 48.79 mmHg), peak (4.50 ± 4.04 to 1.50 ± 2.12) and frequency (3.05 ± 3.29 to 1.41 ± 2.19 /min) reduced after EST. Further reductions to almost 0 were observed 3 weeks later, including common bile duct pressure and SO contraction period. In contrast, in the EEPP group, these manometric data recovered to pre-EST levels, such as CBD pressure (11.5 ± 7.31 vs 11 ± 2.16 mmHg), SO pressure (17.50 ± 17.75 vs 18.20 ± 21.39 mmHg) and SO contraction amplitude (53.67 ± 21.54 vs 60.00 ± 36.08 mmHg). However, no significant differences were observed by Student t-test. Conclusions In this porcine study, EEPP had accelerated and improved papillary healing after EST, and preserved SO function.

show abstract

Effects of sphincter of Oddi motility on the formation of cholesterol gallstones

Cited by 9 publications

References 25 publications

Endoscopic endoclip papilloplasty preserves sphincter of oddi function

Endoscopic endoclip papilloplasty preserves sphincter of oddi function

Changes in the interstitial cells of Cajal in the gallbladder of guinea pigs fed a lithogenic diet

Endoscopic Endoclip Papilloplasty Preserves Sphincter of Oddi Function After Endoscopic Sphincterotomy in Porcine Models

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