EFFECT OF CHOLECYSTECTOMY ON SPHINCTER OF ODDI FUNCTION

Abstract

A prospective clinical and instrumental study of 119 patients with cholelithiasis (CLT) and 71 patient with postcholecystectomy syndrome (PCES), who underwent cholecystectomy (CE) 2-45 years ago, was conducted. We established polymorphism of PCES clinical picture, which was presented by permanent pain syndrome (56.3%) and intermittent pain (43.7%) together with dyspepsia and motor vacuation disorders. Clinical symptoms occurred 1.2-3.7 times more often in a remote period (> 14 years after CE) regardless of the operation type. Various organic and functional GIT pathologies were found in 77.5 % of cases. Their prevalence one year after surgery is 15.1%, 2-14 years – 73.9%, 15-45 years – 84.0%ю. According to manometric data, PCES patients with prolonged pain syndrome are mostly susceptible to the functional disorders of sphincter of Oddi that are manifested through increased pressure and amplitude of contractions of sphinсter, choledochus and duodenum. It was established that the sphincter of Oddi dysfunction increases after the disappearance of reservoir and cumulative functions of the gall bladder, correlating with the development of GIT pathology in a distant period.

Keywords

• sphincter of Oddi
• postcholecystectomy syndrome
• cholecystectomy
• mano-metry