Summary
There are two approaches to endoscopic sphincter of Oddi manometry, the microtransducer
method and the perfusion method. Data reported by us and others are reviewed, with
the aim of comparing the two techniques. Biliary pressure, pancreatic duct pressure,
and sphincter of Oddi phasic wave activity can be measured by both of these methods.
Easy handling and the capability of recording the mode of phasic wave propagation
with a multilumen catheter are present advantages of perfusion manometry over the
microtransducer method. Because there is no need for perfusion of fluid, the equipment
needed for microtransducer manometry is simpler than that needed for the perfusion
method, and the microtransducer technique may be more suitable for prolonged recording.
An inter-study comparison of manometric data is easier with microtransducer manometry,
but must await the collection of more data. Manometric differences between various
diseases are still inconsistent, whereas there is no question of the effect of sphincterotomy
on pressure values, with the exception of pancreatic duct and sphincter pressures.
The possibilities of diagnosing sphincter of Oddi dysfunction, and of predicting the
response to sphincterotomy have been received with enthusiasm. However, whether the
findings obtained by endoscopic manometry over relatively short periods of time can
be considered representative of overall sphincter function is now being questioned
since the presence of physiologic cyclic changes in sphincter of Oddi phasic activity
in phase with the migrating motor complex of the duodenum was demonstrated. Hormonal
or pharmacological stimulation of sphincter activity may help us overcome this problem.
Key words:
Sphincter of Oddi - Manometry - Endoscopic sphincterotomy - Biliary dyskinesia - Post-cholecystectomy
syndrome
