ANALYSES OF MOTILITY OF PAPILLARY SPHINCTER ZONE AND PANCREATIC MAIN DUCTAL PRESSUREIN PATIENTS WITH ALCOHOLIC, IDIOPATHIC OR GALL STONE INDUCED CHRONIC PANCREATITIS

Abstract

To determine the significance of manometric pressure of the pancreatic duct in patients with alcoholic (ALCP), gall stone induuced (GSP) and idiopathic chronic pancreatitis (ICP), a microtransducer was inserted through a duodenoscope to measure pressures in the papillary sphincter zone (SO) and pancreatic main duct (PP) in 20 controls and 38 patients with chronic pancreatitis including 10 cases of ALCP, 7 cases of GSP along with papillitis and 21 cases of ICP. The pancreatic main ductal pressure was significantly higher in the patients with ALCP (55.7±28.9 mmHg), GSP (33.6±16.2 mmHg), or ICP (44.5±25.8 mmHg) than in the controls (16.2±8.7 mmHg), but there was no significant difference between ALCP, GSP and ICP. There was no significant difference between control subjects and ICP in the motility of SO. In ICP there were no correlation between PP and the motility of SO. In ALCP and GSP, the frequency of the papillary sphincter waves was significantly higher than in normal subjcts and there was a correlation between the PP and the motility of So. These data suggest that increased pancreatic ductal pressure in GSP with papillitis or ALCP may be partly due to papillary dysfunction, but not in ICP.