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Gut. Oct 1997; 41(4): 541–544.
PMCID: PMC1891512

Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry


Background—Endoscopic papillary balloon dilatation (EPBD) has been reported as a safe and effective alternative to endoscopic sphincterotomy in the management of common bile duct (CBD) stones; its effect on papillary function has yet to be elucidated.
Aim—To investigate sphincter of Oddi (SO) motility before and after EPBD to determine its effect on SO function.
Patients and methods—The papillary function of 10 patients with CBD stones was studied using endoscopic manometry before and one week after EPBD. The manometric studies were repeated one month after EPBD in seven patients.
Results—One week after EPBD, CBD pressure, SO peak pressure, SO basal pressure, and SO frequency decreased significantly. One month after EPBD, however, all parameters increased although the increases in SO basal pressure and CBD pressure were not significant. There was no significant difference in values of any parameter before and one month after EPBD. No serious complications occurred.
Conclusion—These data suggest at least partial recovery of papillary function one month after the procedure. EPBD seems to preserve papillary function in treatment of CBD stones; a longer term follow up study with SO manometry should be performed to clarify the effect of EPBD on SO function.

Keywords: endoscopic papillary balloon dilatation; sphincter of Oddi

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Mac Mathuna P, White P, Clarke E, Lennon J, Crowe J. Endoscopic sphincteroplasty: a novel and safe alternative to papillotomy in the management of bile duct stones. Gut. 1994 Jan;35(1):127–129. [PMC free article] [PubMed]
  • Mathuna PM, White P, Clarke E, Merriman R, Lennon JR, Crowe J. Endoscopic balloon sphincteroplasty (papillary dilation) for bile duct stones: efficacy, safety, and follow-up in 100 patients. Gastrointest Endosc. 1995 Nov;42(5):468–474. [PubMed]
  • May GR, Cotton PB, Edmunds SE, Chong W. Removal of stones from the bile duct at ERCP without sphincterotomy. Gastrointest Endosc. 1993 Nov-Dec;39(6):749–754. [PubMed]
  • Staritz M, Ewe K, Meyer zum Büschenfelde KH. Endoscopic papillary dilation (EPD) for the treatment of common bile duct stones and papillary stenosis. Endoscopy. 1983 May;15 (Suppl 1):197–198. [PubMed]
  • Mac Mathuna P, Siegenberg D, Gibbons D, Gorin D, O'Brien M, Afdhal NA, Chuttani R. The acute and long-term effect of balloon sphincteroplasty on papillary structure in pigs. Gastrointest Endosc. 1996 Dec;44(6):650–655. [PubMed]
  • Okazaki K, Yamamoto Y, Ito K. Endoscopic measurement of papillary sphincter zone and pancreatic main ductal pressure in patients with chronic pancreatitis. Gastroenterology. 1986 Aug;91(2):409–418. [PubMed]
  • Lai KH, Peng NJ, Cheng JS, Lo GH, Wang EM, Wang NM, Huang RL, Chang CF, Lin CK, Chen SM. Gallbladder function and recurrent stones of the biliary tract in patients after endoscopic sphincterotomy. Scand J Gastroenterol. 1996 Jun;31(6):612–615. [PubMed]
  • Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, Liguory C, Nickl N. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991 May-Jun;37(3):383–393. [PubMed]
  • Toouli J, Geenen JE, Hogan WJ, Dodds WJ, Arndorfer RC. Sphincter of Oddi motor activity: a comparison between patients with common bile duct stones and controls. Gastroenterology. 1982 Jan;82(1):111–117. [PubMed]
  • De Masi E, Corazziari E, Habib FI, Fontana B, Gatti V, Fegiz GF, Torsoli A. Manometric study of the sphincter of Oddi in patients with and without common bile duct stones. Gut. 1984 Mar;25(3):275–278. [PMC free article] [PubMed]
  • Gregg JA, Carr-Locke DL. Endoscopic pancreatic and biliary manometry in pancreatic, biliary, and papillary disease, and after endoscopic sphincterotomy and surgical sphincteroplasty. Gut. 1984 Nov;25(11):1247–1254. [PMC free article] [PubMed]
  • Staritz M, Poralla T, Ewe K, Meyer zum Büschenfelde KH. Effect of glyceryl trinitrate on the sphincter of Oddi motility and baseline pressure. Gut. 1985 Feb;26(2):194–197. [PMC free article] [PubMed]
  • Staritz M, Poralla T, Dormeyer HH, Meyer zum Büschenfelde KH. Endoscopic removal of common bile duct stones through the intact papilla after medical sphincter dilation. Gastroenterology. 1985 Jun;88(6):1807–1811. [PubMed]
  • Minami A, Nakatsu T, Uchida N, Hirabayashi S, Fukuma H, Morshed SA, Nishioka M. Papillary dilation vs sphincterotomy in endoscopic removal of bile duct stones. A randomized trial with manometric function. Dig Dis Sci. 1995 Dec;40(12):2550–2554. [PubMed]
  • Geenen JE, Toouli J, Hogan WJ, Dodds WJ, Stewart ET, Mavrelis P, Riedel D, Venu R. Endoscopic sphincterotomy: follow-up evaluation of effects on the sphincter of Oddi. Gastroenterology. 1984 Oct;87(4):754–758. [PubMed]
  • Freeman ML, Nelson DB, Sherman S, Haber GB, Herman ME, Dorsher PJ, Moore JP, Fennerty MB, Ryan ME, Shaw MJ, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996 Sep 26;335(13):909–918. [PubMed]
  • Vaira D, D'Anna L, Ainley C, Dowsett J, Williams S, Baillie J, Cairns S, Croker J, Salmon P, Cotton P, et al. Endoscopic sphincterotomy in 1000 consecutive patients. Lancet. 1989 Aug 19;2(8660):431–434. [PubMed]
  • Caspi B, Schachter M, Lancet M. Infected duplication cyst of ileum masquerading as an adnexal abscess--ultrasonographic features. J Clin Ultrasound. 1989 Jul-Aug;17(6):431–433. [PubMed]
  • Prat F, Malak NA, Pelletier G, Buffet C, Fritsch J, Choury AD, Altman C, Liguory C, Etienne JP. Biliary symptoms and complications more than 8 years after endoscopic sphincterotomy for choledocholithiasis. Gastroenterology. 1996 Mar;110(3):894–899. [PubMed]
  • Seifert E, Gail K, Weismüller J. Langzeitresultate nach endoskopischer Sphinkterotomie. Dtsch Med Wochenschr. 1982 Apr 23;107(16):610–614. [PubMed]
  • Ikeda S, Tanaka M, Matsumoto S, Yoshimoto H, Itoh H. Endoscopic sphincterotomy: long-term results in 408 patients with complete follow-up. Endoscopy. 1988 Jan;20(1):13–17. [PubMed]
  • Escourrou J, Cordova JA, Lazorthes F, Frexinos J, Ribet A. Early and late complications after endoscopic sphincterotomy for biliary lithiasis with and without the gall bladder 'in situ'. Gut. 1984 Jun;25(6):598–602. [PMC free article] [PubMed]
  • Hawes RH, Cotton PB, Vallon AG. Follow-up 6 to 11 years after duodenoscopic sphincterotomy for stones in patients with prior cholecystectomy. Gastroenterology. 1990 Apr;98(4):1008–1012. [PubMed]
  • Jacobsen O, Matzen P. Long-term follow-up study of patients after endoscopic sphincterotomy for choledocholithiasis. Scand J Gastroenterol. 1987 Oct;22(8):903–906. [PubMed]
  • Kozarek RA. Balloon dilation of the sphincter of Oddi. Endoscopy. 1988 Aug;20 (Suppl 1):207–210. [PubMed]

Figures and Tables

Figure 1
: Comparison of CBD pressure before, one week, and one month after EPBD. **p<0.01.
Figure 2
: Comparison of SO basal pressure before, one week, and one month after EPBD. **p<0.01.
Figure 3
: Comparison of SO peak pressure before, one week, and one month after EPBD. *p<0.05, **p<0.01.
Figure 4
: Comparison of SO frequency before, one week, and one month after EPBD. **p<0.01.

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