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Effect of endoscopic sphincterotomy and endoscopic papillary balloon dilation endoscopic retrograde cholangiopancreatographies on the sphincter of oddi

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1726-1733页

作者： Kai Fu Ying-Ying Yang Hui Chen Guang-Xin Zhang Yan Wang Zhi Yin Department of Gastroentero Endoscopy Center Yixing Hospital of Traditional Chinese MedicineWuxi 214200Jiangsu ProvinceChina

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP),with its clinical ad-vantages of less trauma and faster recovery,has become the primary treatment for *** To investigate the effects of different ERCP procedures on the sphincter of *** The clinical data of 91 patients who underwent ERCP at Yixing Hospital of Traditional Chinese Medicine between February 2018 and February 2021 were analyzed *** patients were divided into endoscopic sphinc-terotomy(EST,n=24)and endoscopic papillary balloon dilation(EPBD,n=67)*** duration of operation,pancreatic development,pancreatic sphinc-terotomy,intubation difficulties,stone recurrence,and incidence of reflux cho-langitis and cholecystitis were statistically analyzed in patients with a history of choledocholithiasis,pancreatitis,and oddi sphincter dysfunction in the EST and EPBD *** Differences in hypertension,diabetes,increased bilirubin,small diameter of the common bile duct,or ampullary diverticulum between the two groups were not *** significant differences were observed between the two groups concerning sex and age(oddi sphincter dysfunction were higher in the EST group than in the EPBD *** number of cases of pancreatic development,pancreatic duct sphincterotomy,and difficult intubation were higher in the EST group than in the EPBD *** number of oddi’s sphincter manometries,ERCP surgical outcomes,and guidewires entering the pancreatic duct several times in EST group were lower than those in the EPBD *** numbers of stone recurrences,reflux cholangitis,and cholecystitis were higher in the EST group than in the EPBD *** In summary,common bile duct stones,pancreatitis history,and multiple guided wire introductions into the pancreatic duct are independent risk factors for EST and *** on this evidence,this study can provide

关键词： oddi Cholangiopancreatography Endoscopic retrograde Risk factors Endoscopic sphincterotomy Endoscopic papillary balloon dilation

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Effects of octreotide on gallbladder pressure and myoelectric activity of oddi sphincter in rabbits

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World Journal of Gastroenterology 1998年第3期4卷 58-61页

作者： ZHOU Jian Hua, LIU Chuan Yong, ZHANG Ru Hua, WANG Han Ru and LIU Ke Jing

AIM To observe the effect of octreotide (OT) and somatostatin (SS) on gallbladder pressure and myoelectric activity of SO in rabbits. METHODS Male rabbits fasted for 15h - 18h and anesthetized with urethane. The mean gallbladder pressure (GP) and myoelectric activity of SO were simultaneously measured with a frog bladder connected to a transducer and a pair of copper electrodes. RESULTS After injection of OT (10μg/kg, iv), the GP decreased in 2min and reached the lowest value in about 60min ( P 0 05). Before and after injection of OT, there were no significant differences in increases of myoelectric activity of SO and GP caused by electric stimulation of dorsal motor nucleus of vagus ( P >0 05). CONCLUSION OT and SS decreased GP and myoelectric activity of SO, demonstrating that effects of OT were similar to those of SS. Intravenous injection of OT did not affect the increase of myoelectric activity of SO and GP caused by CCK 8 or electric stimulation of dorsal motor nucleus of vagus.

关键词： octreotide/pharmacology gallbladder/drug effects oddi sphincter/drug effects electrophysiology rabbits somatostatin electric stimulation

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oddi sphincter preserved cholangioplasty with hepaticosubcutaneous stoma for hepatolithiasis

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World Journal of Gastroenterology 2015年第45期21卷 12865-12872页

作者： Yu-Gui Lian Wei-Tao Zhang Zhi Xu Xiao-Feng Ling Li-Xin Wang Chun-Sheng Hou Gang Wang Long Cui Xiao-Si Zhou Department of General Surgery Peking University Third Hospital

AIM: To evaluate the long-term outcomes of oddi sphincter preserved cholangioplasty with hepaticosubcutaneous stoma(OSPCHS) and risk factors for recurrence in ***: From March 1993 to December 2012, 202 consecutive patients with hepatolithiasis underwent OSPCHS at our department. The oddi sphincter preserved procedure consisted of common hepatic duct exploration, stone extraction, hilar bile duct plasty, establishment of subcutaneous stoma to the bile duct. Patients with recurrent stones can undergo stone extraction and/or biliary drainage via the subcutaneous stoma which can be incised under local anesthesia. The long-term results were reviewed. Cox regression model was employed to analyze the risk factors for stone ***: Ninety-seven(48.0%) OSPCHS patients underwent hepatic resection concomitantly. The rate of surgical complications was 10.4%. There was no perioperative death. The immediate stone clearance rate was 72.8%. Postoperative cholangioscopic lithotomy raised the clearance rate to 97.0%. With a median follow-up period of 78.5 mo(range: 2-233 mo), 24.8% of patients had recurrent stones, 2.5% had late development of cholangiocarcinoma, and the mortality rate was 5.4%. Removal of recurrent stones and/or drainage of inflammatory bile via subcutaneous stoma were conducted in 44(21.8%) patients. The clearance rate of recurrent stones was 84.0% after subsequent choledochoscopic lithotripsy via subcutaneous *** regression analysis showed that residual stone was an independent prognostic factor for stone ***: In selected patients with hepatolithiasis, OSPCHS achieves excellent long-term outcomes, and residual stone is an independent prognostic factor for stone recurrence.

关键词： Hepatolithiasis Stone recurrence Sphincter of oddi

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A study on motility of sphincter of oddi in postcholecystectomy syndrome

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医学研究生学报 1991年第2期4卷 180-186页

作者：陈晓星王年吉莫剑忠刘文忠胡运彪萧树东 Jinling Hospital NanjingPR China Shanghai institute of digestive disease ShanghaiPR China

Endoscop c manometry of sphincter of oddi(SO)and serumlevels of gastrin,glucagon,and somatostatin were measured in patients withpostcholecystectomy syndrome(n=12),asymptomatic cholecystectomised pa-tients(n=6),and controlled subjects(n=14).Pentagastrin-stimulated gastricacid secretion test was also performed in part of patients who had symptoms orno symptoms after gallbladder *** results showed that the patientsof symptomatic group had hypertonic dyskinesia of SO as shown by deep andwide waves superimposed on high basal pressure plateau of *** symptoma-tic group also had a higher serum level of gastrin and a greater BAO than tho-se of other two *** difference of serum levels of glucagon and soma-tostatin was found among these three *** hypertonic dyskinesia of SOand hypergastrinemia are considered as possibly important factors in the patho-genesis of postcholecystectomy syndrome.

关键词： endoscopic manometry sphincter of oddi gastrin glucagon somatostatin postcholecystectomy syndrome

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oddi括约肌松驰症2例报告

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实用放射学杂志 1998年第12期14卷 60-61页

作者：张孟增,路福志,刘沧君河北省邢台市人民医院放射科

奥狄（Ｏｄｄｉ）氏括约肌松驰症罕见，我院遇到２例，经手术、胃镜证实，报告如下：例１女，５６岁。上腹部间断性疼痛２年，２年前无明显诱因上腹部疼痛难忍，约半小时后自行缓解。近２个月来病情加重。有腹胀、便秘史。查体未发现异... 详细信息

奥狄（Ｏｄｄｉ）氏括约肌松驰症罕见，我院遇到２例，经手术、胃镜证实，报告如下：例１女，５６岁。上腹部间断性疼痛２年，２年前无明显诱因上腹部疼痛难忍，约半小时后自行缓解。近２个月来病情加重。有腹胀、便秘史。查体未发现异常。Ｘ线检查：胃呈钩型，窦部小区呈...

关键词：括约肌结石手术胃镜 oddi 十二指肠降部

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Effects of sphincter of oddi motility on the formation of cholesterol gallstones

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World Journal of Gastroenterology 2016年第24期22卷 5540-5547页

作者： Zhong-Hou Rong Hong-Yuan Chen Xin-Xing Wang Zhi-Yi Wang Guo-Zhe Xian Bang-Zhen Ma Cheng-Kun Qin Zhen-Hai Zhang Department of Hepatobiliary Surgery Provincial Hospital Affiliated to Shangdong University

AIM: To investigate the mechanisms and effects of sphincter of oddi(SO) motility on cholesterol gallbladder stone formation in guinea ***: Thirty-four adult male Hartley guinea pigs were divided randomly into two groups, the control group(n = 10) and the cholesterol gallstone group(n = 24), which was sequentially divided into four subgroups with six guinea pigs each according to time of sacrifice. The guinea pigs in the cholesterol gallstone group were fed a cholesterol lithogenic diet and sacrificed after 3, 6, 9, and 12 wk. SO manometry and recording of myoelectric activity were obtained by a multifunctional physiograph at each stage. Cholecystokinin-A receptor(CCKAR) expression levels in SO smooth muscle were detected by quantitative real-time PCR(q RT-PCR) and serum vasoactive intestinal peptide(VIP), gastrin, and cholecystokinin octapeptide(CCK-8) were detected by enzyme-linked immunosorbent assay at each stage in the process of cholesterol gallstone ***: The gallstone formation rate was 0%, 0%, 16.7%, and 83.3% in the 3, 6, 9, and 12 wk groups, respectively. The frequency of myoelectric activity in the 9 wk group, the amplitude of myoelectric activity in the 9 and 12 wk groups, and the amplitude and the frequency of SO in the 9 wk group were all significantly decreased compared to the control group. The SO basal pressure and common bile duct pressure increased markedly in the 12 wk group, and the CCKAR expression levels increased in the 6 and 12 wk groups compared to the control group. Serum VIP was elevated significantly in the 9 and 12 wk groups and gastrin decreased significantly in the 3 and 9 wk groups. There was no difference in serum CCK-8 between the ***: A cholesterol gallstone-causing diet can induce SO dysfunction. The increasing tension of the SO along with its decreasing activity may play an important role in cholesterol gallstone formation. Expression changes of CCKAR in SO smooth muscle and serum VIP and CCK-

关键词： Cholesterol gallstone Sphincter of oddi Manometry Myoelectric activity Cholecystokinin-A receptor

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oddi括约肌术中和经内镜测压的比较

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国际外科学杂志 1993年第2期 109-110页

作者：张延令

oddi括约肌测压(SOM)可通过很多途径,如经ERCP、术中切开十二指肠经乳头插管、经胆囊管或胆总管、经T管或经皮经肝等等,作者比较同一组病例中术前经内镜以及术中经十二指肠切开括约肌成形时的SOM数值。全组74例患者主诉原发性胰腺炎或... 详细信息

oddi括约肌测压(SOM)可通过很多途径,如经ERCP、术中切开十二指肠经乳头插管、经胆囊管或胆总管、经T管或经皮经肝等等,作者比较同一组病例中术前经内镜以及术中经十二指肠切开括约肌成形时的SOM数值。全组74例患者主诉原发性胰腺炎或原因不明的胆胰源性疼痛,均在6周内进行了这两种途径的SOM测定。35例测定了胆管段oddi括约肌的压力,其内镜和术中测得的括约肌基础压分别为41.1±6.4mmHg和42.0±6.8 mmHg(P>0.05),其胆管括约肌相压力、频率及持续时间也无明显差别。55例测定了胰管括约肌压力,其内镜和术中经胆道括约肌成形时测得的基础括约肌压分别为119.9±9.9-mmHg和102·7±8.7 mmHg(P>0.05),其胰管括肌相频率及持续时间也无明显差别;但经内镜测得的

关键词：括约肌 oddi 括约肌成形内镜术中测压

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oddi括约肌成形术9例体会

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中国实用外科杂志 1992年第11期 47-48页

作者：顾凤元潘人伟浙江湖州市第二医院普外科 313000 浙江湖州市第二医院普外科

我院自1986年始,在完成oddi括约肌切开成形的基础上,再舌状切除部分胆总管前壁及十二指肠后壁作孔洞式缝合共9例,男5例,女4例。年龄28～66岁。其中oddi括约肌结石嵌顿伴狭窄6例,十二指肠乳头狭窄3例。本组9例无手术死亡,术后无胆汁及胰... 详细信息

我院自1986年始,在完成oddi括约肌切开成形的基础上,再舌状切除部分胆总管前壁及十二指肠后壁作孔洞式缝合共9例,男5例,女4例。年龄28～66岁。其中oddi括约肌结石嵌顿伴狭窄6例,十二指肠乳头狭窄3例。本组9例无手术死亡,术后无胆汁及胰液漏,近期效果较好。随访2～6年,9例术后均无胆道反复感染、结石再生及再次手术史。

关键词：括约肌切开十二指肠小肠胆总管切开 oddi

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人类oddi括约肌胆囊收缩素受体的特性

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国际外科学杂志 1994年第3期21卷 175-176页

作者：傅德良

胆囊收缩素（CCK）与oddi括约肌（SO）的运动密切相关,但CCK与人类SO之间的直接关系不清楚.本文研究的目的旨在通过CCK对人类SO组织CCK受体的作用及对离体SO运动影响的研究,探讨人类SO组织CCK受体的特性.方法:人类SO取自于肝移植手术的... 详细信息

胆囊收缩素（CCK）与oddi括约肌（SO）的运动密切相关,但CCK与人类SO之间的直接关系不清楚.本文研究的目的旨在通过CCK对人类SO组织CCK受体的作用及对离体SO运动影响的研究,探讨人类SO组织CCK受体的特性.方法:人类SO取自于肝移植手术的供体.一半作快速冷冻切片,并在22℃、PH为6.5内含;I-BH-CCK-8的培养液中完成CCK-8与SO组织上CCK受体的结合,用品体闪烁法测定结合放射活性,用自身放射显像法显示两者结合的位点.另一半切成环形及纵向的肌条,垂直悬挂于37℃、通过95%O;及5%CO;的浴糟中,连接以带有放大记录仪的等长收缩换能器,用于观察CCK-8、去硫酸基CCK-8及胃泌素对肌条运动的影响及阿托品、河豚毒素对CCK-8作用的影响.

关键词：人类 SO 胃泌素促胃液素多肽硫酸基 CCK oddi 括约肌

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胰腺癌导致oddi′s括约肌功能异常1例报告

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实用放射学杂志 1995年第7期11卷 440-441页

作者：胡新明湖北省应城盐矿职工医院放射科

胰腺癌导致ｏｄｄｉ′ｓ括约肌功能异常１例报告湖北省应城盐矿职工医院放射科胡新明患者，男性，６９岁。剑突下反复胀痛月余，继而出现乏力、纳差、尿黄、腹痛向背部放射，全身皮肤瘙痒。于１９９３一０４一２５以黄疸性肝炎住院。查... 详细信息

胰腺癌导致ｏｄｄｉ′ｓ括约肌功能异常１例报告湖北省应城盐矿职工医院放射科胡新明患者，男性，６９岁。剑突下反复胀痛月余，继而出现乏力、纳差、尿黄、腹痛向背部放射，全身皮肤瘙痒。于１９９３一０４一２５以黄疸性肝炎住院。查体及实验检查：慢性病容，全身皮肤粘...

关键词：胰腺癌 oddi 括约肌功能异常

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