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Human sphincter of oddi motility and cholecystokinin response following liver transplantation

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Abstract

The reported incidence of sphincter of Oddi dysfunction following orthotopic liver transplantation has ranged from 3% to 7%. If sphincteric dysfunction is unrecognized, therapy may be inappropriate; when recognized, extensive surgery may be required. To prospectively identify patients with sphincteric dysfunction, we performed sphincter of Oddi motility studies through the t-tube tract three months after transplantation. Baseline sphincter motility and response to intravenous cholecystokinin were evaluated. The results of 10 subjects are reported; nine had normal basal sphincter pressure (16±5.8 mm Hg), and all had normal frequency (3.6±1/min), amplitude (86±31 mm Hg), and duration (4.5±1 sec) of phasic contractions. One subject had an elevated basal pressure (47 mm Hg). All, including the subject with elevated basal pressure, demonstrated a normal response to intravenous cholecystokinin with significant inhibition of phasic contraction frequency and amplitude. We demonstrate that simultaneous studies of the sphincter and duodenum can be obtained via the t-tube tract, providing the opportunity for prospective evaluation of sphincteric function. We conclude that sphincter of Oddi function usually remains normal following liver transplantation with choledochocholedochostomy.

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Authors and Affiliations

  1. Departments of Internal Medicine, Radiology, and Surgery, University of Virginia Health Sciences Center, 22908, Charlottesville, Virginia

    Robert D. Richards MD, Paul Yeaton MD, Hubert A. Shaffer Jr. MD, Daniel J. Pambianco MD, Timothy L. Pruett MD, William C. Stevenson MD, Ravinder K. Mittal MD &  Richard W. McCallum MD

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  1. Robert D. Richards MD
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  2. Paul Yeaton MD
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  3. Hubert A. Shaffer Jr. MD
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  4. Daniel J. Pambianco MD
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  5. Timothy L. Pruett MD
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  6. William C. Stevenson MD
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  7. Ravinder K. Mittal MD
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  8. Richard W. McCallum MD
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Richards, R.D., Yeaton, P., Shaffer, H.A. et al. Human sphincter of oddi motility and cholecystokinin response following liver transplantation. Digest Dis Sci 38, 462–468 (1993). https://doi.org/10.1007/BF01316500

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  • DOI: https://doi.org/10.1007/BF01316500

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