THIS is the report of an attempt to compare the emptying properties of the common duct in patients in whom sphincterotomy had been performed with those in whom the sphincter had been left intact and to demonstrate differences in hydrodynamic properties between the two groups.
In 10 patients the common duct had been explored but the sphincter had not been sectioned. In a second group of 6 patients transduodenal A B FIG. 22.-Two cholangiograms from a 49-year-old woman 10 days after exploration of the common duct. A, Shows free flow into the duodenum with slight pancreatic reflux. B, Shows the closure of the lower end of the duct by duodenal muscular spasm. This was taken 5 min. after 10 mg. morphine had been given intravenously. Note increase of pancreatic reflux.
sphincterotomy had been carried out. The problem was to decide whether sphincterotomy had any effect.
All of the patients had undergone cholecystectomy and consequently no information on gallbladder behaviour was obtained. From the experimental point of view, the fact that a cholecystectomy had been performed might be an advantage as any modifying influences due to the presence of the gallbladder were eliminated.
CHOICE OF METHODS OF INVESTIGATION
The standard methods of investigation of environmental pressure and emptying behaviour of the biliary tree are cholangiography, pressure readings, and, more recently, study of pressure/flow relationships.