Abstract
It is essential for the diagnosis of a functional disturbance in the papillary region to make minute observations on endoscopical features of the papilla and on pictures of the bile duct obtained by EPCG. In order to obtain a more objective estimation of pathological conditions in the papillary region, the authors devised a manometer. The manometer was placed on the tip of a canula and inserted into the terminal portion of the choledochus and the pancreatic duct. Manometry was performed in 10 cases, 8 out of which had undergone sphincteroplasty. The pressure of the choledochus in patients after sphincteroplasty is 50-100mmH2O, the pressure of the pancreatic duct is 80mmH2O, and the pressure of the choledochus in patients with papillary carcinoma is 190mmH2O. On the contrary the pressure of the untreated patient (gastritis) is 90mmH2O. Manometry by duodenofiberscopy is a very useful procedure to determine the indication for re-operation in patients with postoperative symptoms after cholecysfectomy and sphincteroplasty, and is also valuable in elucidating the functional disorders of the papillary region seen in chronic pathological state of the pancreas and liver.
