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The pathophysiology, evaluation and management of motility disorders of the biliary tract.
- Source :
-
Gastroenterology clinics of North America [Gastroenterol Clin North Am] 1989 Jun; Vol. 18 (2), pp. 425-35. - Publication Year :
- 1989
-
Abstract
- Significant advances in the understanding of biliary tract physiology have occurred during the past 20 years. Through careful studies in animals, the fluid mechanics and normal regulatory mechanisms involved in sphincter of Oddi function have been partially elucidated. Many of the basic concepts have been validated in human studies by newly developed testing methods. Endoscopic retrograde cholangiopancreatography is crucial in demonstrating both normal anatomy and mechanical or structural abnormalities of the duct system. Fat-meal--or CCK-stimulated ultrasonography and quantitative hepatobiliary scintigraphy offer reliable and noninvasive screening methods to evaluate patients with suspected sphincter of Oddi dysfunction. Biliary manometry is key in defining normal and abnormal motility patterns of the sphincter of Oddi region. The existence of the problem is being solidly established, but the optimal therapy is still somewhat unclear. The use of endoscopic balloon dilatation is not encouraging; drug therapy holds promise, but must be subjected to careful clinical trials. Sphincter surgery is fading from use and is being replaced by endoscopic sphincterotomy. Unfortunately the long-term results of sphincterotomy and the overall safety of the procedure are not known. Biliary motility problems do exist, but both diagnostic studies and therapeutic maneuvers require judgement and skill in their application. Use of potentially harmful treatments must be employed only after careful and thorough testing.
- Subjects :
- Biliary Tract diagnostic imaging
Biliary Tract Diseases diagnosis
Biliary Tract Diseases therapy
Dietary Fats pharmacology
Humans
Manometry
Muscular Diseases diagnosis
Muscular Diseases therapy
Radionuclide Imaging
Sincalide
Sphincter of Oddi physiology
Ultrasonography
Biliary Tract Diseases physiopathology
Muscular Diseases physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0889-8553
- Volume :
- 18
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Gastroenterology clinics of North America
- Publication Type :
- Academic Journal
- Accession number :
- 2668177