The Size of the Papilla of Vater and Its Relation to Its Height in Comparison with the Visibility of the Sphincter of Oddi before and after Cholecystectomy

Abstract

This study investigated the changes in the surface area and height of the papilla of Vater (PV) and the visibility of the sphincter of Oddi complex (SOK) using endoscopic ultrasound (EUS) examinations of 80 patients with symptomatic gallstones before and at 3 and 6 months after cholecystectomy. Following surgery, 50 patients experienced early atypical symptoms characteristic of postcholecystectomy syndrome (PCS) and 30 patients were asymptomatic. The PV measurements were greater in all patients compared with normal reference values and increased significantly from before surgery to 3 months postsurgery. At 6 months postsurgery, both the surface area and height of the PV had significantly decreased to preoperative values but remained higher than normal. The proportion of patients with a visible SOK had increased by 3 months postsurgery but had reduced again by 6 months. There were no significant differences between symptomatic and asymptomatic patients, suggesting that the changes observed in the PV and SOK do not explain the presence of the atypical symptoms of PCS.

Manometric Measurement of the Sphincter of Oddi in Patients with Common Bile Duct Stones: A Consecutive Study of the Han Population of China

“…In our study, there was no difference of SO motor function between patients with or without PAD. Our results are similar to the study by Skalicky [24] that there is no correlation between PAD and symptoms in patients with CBD stones. PAD-induced pancreatobiliary reflux [25] may be the main reason for the increased incidence of CBD stones [26].…”

Dynamic Changes of Echogenicity and the Size of the Papilla of Vater before and after Cholecystectomy

“…The SPV also increases after cholecystectomy, a procedure that is associated with a number of accompanying factors (anatomical, psychological, stress, functional) that can influence its integrity and is registered as altered ultrasound scattering. Surgery also increases the visibility of the SO complex, which is described in more detail in the companion paper in the same issue of this journal, 27 and which appears to be a novel finding.…”

“…28,33 The calculated SPV at the three time-points for the 50 symptomatic patients and 30 asymptomatic patients is presented in Tables 1 and 2 of the companion paper in the same issue of this journal. 27 In brief, patients with symptomatic gallstones with or without atypical symptoms had significantly greater SPV values (range 70.0 -78.9 mm 2 ) compared with the 24 healthy controls at the preoperative time-point and at 3 months M Skalicky Impact of cholecystectomy on the papilla of Vater: echogenicity after surgery (P < 0.05). At 6 months after surgery, the SPV values were significantly reduced compared with the values at 3 months (P < 0.001), but the values were not significantly different compared with the preoperative values and they remained greater than control values.…”

“…27 Of the 80 cholecystectomized patients, 50 developed atypical symptoms postcholecystectomy and 30 were asymptomatic.…”

“…A companion paper in the same issue of this journal describes the changes in the surface area and height of the PV and the visibility of the SO complex in the same group of patients. 27…”