Endoscopic manometry of the pancreatic duct and sphincter zone in patients with chronic pancreatitis

Abstract

A possible mechanism for pain in alcohol-induced chronic pancreatitis is increased pancreatic duct pressure. A study has been done to compare sphincter of Oddi and pancreatic duct pressures in normal controls and patients with alcohol-induced chronic pancreatitis who had recently had pain or who were pain-free. Pressures were measured in the sphincter of Oddi in 10 controls and 33 patients, in the pancreatic duct in six controls and 15 patients, and in the common bile duct in four controls and five patients during station pull-through at the time of an endoscopic retrograde cholangiopancreatogram. There was no significant difference in the mean pressures in the pancreatic duct, sphincter of Oddi (basal and phasic), and frequency of papillary contraction when comparing patients with alcoholic pancreatitis and controls. There was also no difference between patients with or without pain and patients with or without strictures. This study has not confirmed the hypothesis that increased pancreatic duct pressures may be incriminated as a possible mechanism of pain in alcoholic-induced chronic pancreatitis.

Motility of the biliary system

“…In patients with recurrent or chronic alcoholic pancreatitis, the sphincter of Oddi generally exhibits normal findings on endoscopic sphincter manometry (35,129). In contrast, the sphincter of Oddi in a substantial minority of patients with unexplained idiopathic recurrent pancreatitis has elevated basal sphincter pressure (67, 77).…”

Der Effekt von Mastzellstabilisatoren auf die Schmerzentstehung und -wahrnehmung bei akuter und chronischer Pankreatitis

“…Dies führt zu einem starken Einstrom von Calcium in die Azinuszellle und damit zur Zellschädigung (Swain et al, 2020). Ein direkter Zusammenhang zwischen Schmerzempfinden und einem erhöhten Druck und/oder anatomischen Veränderungen konnte bisher nicht festgestellt werden (Novis et al, 1985, Frokjaer et al, 2013. Besteht jedoch eine längerfristige Analgetikatherapie aufgrund der Schmerzen, wird eine Intervention zur Schmerzreduktion empfohlen, wobei eine chirurgische Therapie der endoskopischen im langfristigen Verlauf überlegen ist (Cahen et al, 2011).…”

Neurological Damage and Duodenopancreatic Reflux in the Pathogenesis of Alcoholic Pancreatitis

“…51 Mean basal OS and PD pressures are similar in normal controls and in patients with AP in the basal fasting, unstimulated state. [52][53][54] However, intragastric ethanol reduced peak OS pressure from 75 ± 26 mm Hg to 39 ± 19 mm Hg, and basal pressure from 30 ± 19 mm Hg to 11.8 ± 6 mm Hg. 53 No drugs were given before endoscopy.…”