Ethanol Inhibits Sphincter of Oddi Motility

被引:14
作者
Tierney S. [1 ]
Qian Z. [1 ]
Lipsett P.A. [1 ]
Pitt H.A. [1 ]
Lillemoe K.D. [1 ,2 ]
机构
[1] Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD
[2] Baltimore, MD 21287-4603, Blalock 603
关键词
Gallstone Formation; Cholesterol Gallstone; Motility Index; Alcoholic Pancreatitis; Pigment Stone;
D O I
10.1016/S1091-255X(98)80075-9
中图分类号
学科分类号
摘要
Patients with alcohol-induced liver disease are at increased risk for pigment gallstones, which are known to be particularly associated with biliary stasis. Although the effects of ethanol on the sphincter of Oddi are thought to contribute to alcoholic pancreatitis, the precise effects of ethanol on the biliary component of the sphincter of Oddi are unclear. In the prairie dog the common bile and pancreatic ducts enter the duodenum separately, facilitating pressure measurement in the sphincter choledochus in isolation. We therefore used this model to test the hypothesis that ethanol administration alters sphincter of Oddi motility. Twenty-six male prairie dogs fed a nonlithogenic diet were studied. With the animals under α-chloralose anesthesia, a side-hole pressure-monitored perfusion catheter was positioned in the sphincter of Oddi and femoral arterial and venous catheters were placed. Sphincter of Oddi phasic wave frequency (F), amplitude (A), and motility index (MI = F × A) and arterial blood pressure were monitored at 10-minute intervals before (baseline), during 20-minute intravenous infusions of 15 mg/kg (n = 9), 150 mg/kg (n = 10), and 1.5 g/kg (n = 7) ethanol and for 20 minutes after ethanol infusion. The 15 mg/kg dose of ethanol had no effect, the 150 mg/kg dose tended to reduce sphincter of Oddi motility, and significant reductions in sphincter of Oddi amplitude and motility index were seen at the 1.5 g/kg dose. These data demonstrate that ethanol infusion inhibits both sphincter of Oddi amplitude and motility index and that this effect persists for at least 20 minutes following ethanol infusion. Ethanol may contribute to gallstone formation by altering biliary sphincter motility.
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页码:356 / 362
页数:6
相关论文
共 32 条
[1]  
Harvey M.H., Cates M.C., Reber H.A., Possible mechanisms of acute pancreatitis induced by alcohol, Am J Surg, 155, pp. 49-56, (1988)
[2]  
Becker J.M., Sharp S., Effect of alcohol on cyclical myoelectric activity of the opossum sphincter of Oddi, J Surg Res, 38, pp. 343-349, (1985)
[3]  
Coelho J.C.U., Moody F.G., Senniger N., Weisbrodt N.W., Effect of alcohol upon myoelectric activity of the gastrointestinal tract and pancreatic and biliary duct pressures, Surg Gynecol Obstet, 160, pp. 528-532, (1985)
[4]  
Viceconte G., Effects of ethanol on the sphincter of Oddi: An endoscopic manometric study, Gut, 24, pp. 20-27, (1983)
[5]  
Guelrud M., Mendoza S., Rossiter G., Gelrud D., Rosiiter A., Sourney P., Effect of local instillation of alcohol on sphincter of Oddi motor activity: Combined ERCP and manometry study, Gastrointest Endosc, 37, pp. 428-432, (1991)
[6]  
Pirola R.C., Davis E., Effects of ethyl alcohol on sphincter resistance at the choledocho-duodenal junction in man, Gut, 9, pp. 557-580, (1968)
[7]  
Bouchier I., Postmortem study of the frequency of gallstones in patients with cirrhosis of the liver, Gut, 10, pp. 705-710, (1969)
[8]  
Nicholas P., Rinaudo P., Conn H., Increased incidence of cholelithiasis in Laennec's cirrhosis, Gastroenterology, 63, pp. 112-121, (1972)
[9]  
Schwesinger W., Kurtin W., Levine B., Page C., Cirrhosis and alcoholism as pathogenetic factors in pigment gallstone formation, Ann Surg, 201, pp. 319-322, (1985)
[10]  
Kaufman H.S., Magnuson T.H., Lillemoe K.D., Frasca P., Pitt H.A., The role of bacteria in gallbladder and common duct stone formation, Ann Surg, 209, pp. 584-592, (1989)