Pain associated with phase III of the duodenal migrating motor complex in patients with postcholecystectomy biliary dyskinesia.
Gastrointest Endosc
; 51(5): 528-34, 2000 May.
Article
em En
| MEDLINE
| ID: mdl-10805836
ABSTRACT
BACKGROUND:
Correlation between various gastrointestinal events and particular aspects of the migrating motor complex has been reported. This study correlates postcholecystectomy pain to variations in biliary pressure associated with the duodenal motor cycle.METHODS:
In 18 patients with postcholecystectomy pain and 10 control subjects, biliary and duodenal pressures were recorded simultaneously with microtransducers. After recording a spontaneous cycle, morphine was administered to induce a premature phase III and spasm of the sphincter of Oddi, and then cerulein was administered to stop the spasm.RESULTS:
Transient but significant elevations of biliary pressure occurred at duodenal phase III in both groups, but a greater percentage of the patients developed pain during phase III (89% vs. 20%, p<0.01). Morphine produced premature phase III and biliary pressure elevation, which were accompanied by pain more frequently in the patients than in the control subjects (78% vs. 30%, p<0.05). Biliary pressure dropped after the cerulein injection, relieving the pain in 13 of 14 patients and in 2 of 3 control subjects who had morphine-induced pain. The phase III-related pain was relieved by endoscopic sphincterotomy in 14 of 15 patients.CONCLUSIONS:
The cyclic elevation of biliary pressure in coordination with phase III of the duodenal motor cycle may contribute to the development of pain in patients with postcholecystectomy biliary dyskinesia.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dor Pós-Operatória
/
Discinesia Biliar
/
Complexo Mioelétrico Migratório
/
Síndrome Pós-Colecistectomia
/
Duodeno
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Japão