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Spasm and operative cholangiography
Archives of Surgery (Chicago, Ill. : 1960)
|January 1, 1975
Summary
Sphincter of Oddi spasm during operative cholangiography can lead to misinterpretations and unnecessary surgeries. Recognizing anesthetic and operative factors causing spasm prevents common duct explorations, reducing patient morbidity and mortality.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Radiology
Background:
- Operative cholangiography is a standard procedure for detecting common bile duct stones during biliary surgery.
- Anesthetic agents and surgical manipulation can induce sphincter of Oddi spasm, potentially leading to inaccurate cholangiogram interpretations.
Purpose of the Study:
- To highlight the hazards of sphincter of Oddi spasm during operative cholangiography.
- To emphasize the role of medications and operative factors in causing spasm.
- To reduce unnecessary common duct explorations and associated complications.
Main Methods:
- Review of six case reports illustrating complications related to sphincter of Oddi spasm.
- Analysis of the influence of anesthetic agents (e.g., fentanyl citrate, morphine sulfate) and operative manipulation on sphincter of Oddi function.
Main Results:
- Sphincter of Oddi spasm can cause misinterpretation of operative cholangiograms.
- This misinterpretation may lead to unnecessary common duct explorations, increasing patient morbidity and mortality.
- Specific medications and operative factors were identified as exacerbating spasm.
Conclusions:
- Recognition of factors inducing sphincter of Oddi spasm is crucial for accurate cholangiography.
- Preventing spasm can avoid unnecessary common duct explorations, thereby reducing morbidity and mortality in biliary tract operations.