Study of Sphinctric Function in Relation to Intraductal Pressure and Its Decreasing Curves

Kusano, Tasuku

doi:10.5833/jjgs.9.14

Cited by 2 publications

(4 citation statements)

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“…basal pressure). Although many ideas have been proposed, 26‐32 we believe that the basal pressure is the value measured free of any loading on the biliary tract in clinical studies. Suzuki et al 33 reported a basal pressure of 2.5‐7 cmH 2 O (mean, 4.15 cmH 2 O).…”

Section: Discussionmentioning

confidence: 97%

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Cholangio‐venous reflux of biliary contents through paracellular pathways between hepatocytes in patients with acute cholangitis

Takada

Takikawa

Sawada

et al. 2021

J Hepato Biliary Pancreat

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Background We re‐analyzed data on cholangio‐venous reflux from a clinical study conducted prospectively on 22 patients in 1974. Method Direct cholangiography was performed with indocyanine green (ICG) mixed into UrographinR under monitoring of intrabiliary pressure, and the participants were allocated to three groups according to whether ICG leakage into the blood, signs of infection, or both, were present. Results The intrabiliary pressure of six patients negative for both ICG leakage and signs of infection was approximately 19.5 (median, [range 18‐22]) cmH2O. In contrast, for the five patients positive for ICG leakage but negative for signs of infection, the intrabiliary pressure was higher (median 32.0 [range 27‐41) cmH2O]. The 11 patients positive for both ICG leakage and signs of infection had the highest intrabiliary pressure (median 48.0 [range 33‐77] cmH2O). Our analyses revealed that, as the intrabiliary pressure increased, the status of ICG leakage and signs of infection appeared in a stepwise fashion. Conclusion Our findings suggest that the tight junctions sealing the bile canaliculi deteriorated with increasing intrabiliary pressure, resulting in reflux of the biliary contents into the vascular system via paracellular pathways between hepatocytes.

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Section: Discussionmentioning

confidence: 97%

“…basal pressure). Although many ideas have been proposed, [26][27][28][29][30][31][32] we believe that the basal pressure is the value measured free of any loading on the biliary tract in clinical studies. Suzuki et al 33 junctions between hepatocytes was maintained up to an intrabiliary pressure of at least 20 cmH 2 O.…”

Section: Discussionmentioning

confidence: 99%

Cholangio‐venous reflux of biliary contents through paracellular pathways between hepatocytes in patients with acute cholangitis

Takada

Takikawa

Sawada

et al. 2021

J Hepato Biliary Pancreat

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“…We have regarded the duration of pressure falling over 30 sec (normal limit) as indicating a prolonged dumping time. But the normal limit varies with researchers; 10 sec (Ito 1973) or 20 sec (Tsuda 1975;Kusano 1976). But, in our control cases (normal group), the dumping time became shortened with increases in perfusion volume, indicating that the elasticity of normal bile duct is unexpectedly low.…”

Section: Discussionmentioning

confidence: 99%

“…This pressure has generally been believed to manifest the choledochal terminal resistance (Yoshioka 1959;Noro 1972;Kusano 1976), or the spasm of the sphincter of Oddi (Saito 1975). We investigated the residual pressure mainly from the degree of choledochal mural disorders and found that cases of ductal mural abnormalities surely indicate a high level of the residual pressure, and cases of prolonged dumping time are frequently associated with ductual mural disorder.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of biliary pressure by perfusion method and its significance.

Suzuki¹,

Takahashi²,

Uematsu³

et al. 1983

Tohoku J. Exp. Med.

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The present authors have made it a rule to use a modified Mellet-Guy's method for measuring pressure in the bile duct. The determined manometric pressure expressed in curve has been classified into (a) basal pressure, (b) rising time, (c) perfusion pressure, (d) dumping time and (e) residual pressure. The basal pressure (a) represents a static pressure free from any load in the bile duct. The rising time (b) varies with factors including the measuring apparatus, duetal elasticity and capacity, resistance at the choledochal terminal, and the volume of physiological saline infused. The perfusion pressure (c) is likely to undergo interference of a variety of factors such as the duetal diameter, mural elasticity and thickness, resistance at the choledochal terminal, along with the measuring apparatus. The dumping time (d), free from the influence of the measuring apparatus, is considered to be an important guide for us to guess the condition of choledochal terminal. The residual pressure (e) and the trend of manometric pressure curve help us to surmise the choledochal terminal resistance and the presence of duetal abnormalities. After all, among the above factors, the dumping time and the residual pressure are apparently available for objective evaluation of bile duct pressure. biliary pressure; cholelithiasis; bile duct; papilla of Vater In the biliary tract surgery, it is important to ascertain abnormalities, either functional or organic, in the terminal portion of the common bile duct. Bile duct pressure, one of the essential factors with relation to the condition of the biliary tract, is usually determined during and after operation. The intraoperative measurement is made in an effort to confirm the presence or absence of stenosis at the choledochal terminal and to determine the indication for transduodenal sphincteroplasty, while the postoperative determination via a T-tube is made to judge an adequate time for withdrawing the T-tube inserted into the common bile duct. In search of a reliable technique for identifying disorder in the terminal portion of the bile duct along with the development of intraoperative cholangiography, radioman.ometry was devised by Caroli (1942) and Mallet-Guy (1952) to observe abnormal conditions of that region. Their original methods have since been improved remarkably. In this paper, we report the details of our perfusion method and its clinical significance.

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Study of Sphinctric Function in Relation to Intraductal Pressure and Its Decreasing Curves

Cited by 2 publications

References 0 publications

Cholangio‐venous reflux of biliary contents through paracellular pathways between hepatocytes in patients with acute cholangitis

Cholangio‐venous reflux of biliary contents through paracellular pathways between hepatocytes in patients with acute cholangitis

Evaluation of biliary pressure by perfusion method and its significance.

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