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Sphincter of Oddi motility.

P Funch-Jensen1

  • 1Surgical Gastroenterological Dept. L, Arhus kommunehospital, University of Aarhus.

Acta Chirurgica Scandinavica. Supplementum
|January 1, 1990
PubMed
Summary

The sphincter of Oddi (SO) is a true sphincter, crucial for regulating biliary and pancreatic flow and preventing duodenal reflux. Its complex physiology involves nervous and hormonal control, with activity patterns distinct from duodenal contractions.

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Area of Science:

  • Gastroenterology
  • Biliary and Pancreatic Physiology
  • Sphincter of Oddi Function

Background:

  • The sphincter of Oddi (SO) anatomy is complex, with discrepancies between anatomical and manometric studies regarding its divisions (choledochal, pancreatic, ampullar).
  • The functional classification of the SO as a true sphincter has been debated due to its activity patterns relative to duodenal contractions.

Purpose of the Study:

  • To review the anatomy, physiology, and methods for investigating the sphincter of Oddi (SO).
  • To consolidate evidence supporting the SO as a true sphincter.
  • To outline the neural and hormonal control mechanisms and pathological implications of SO dysfunction.

Main Methods:

  • Review of anatomical and manometric studies on the sphincter of Oddi (SO).
  • Discussion of direct and indirect manometric techniques for assessing SO activity.
  • Analysis of physiological data including slow waves, motor complexes, and neural/hormonal influences.

Main Results:

  • Evidence strongly supports the sphincter of Oddi (SO) as a true sphincter, with distinct activity patterns often dissociated from duodenal contractions.
  • The SO exhibits slow waves and activity linked to duodenal migrating motor complexes, influenced by sympathetic, parasympathetic, and hormonal factors (e.g., cholecystokinin).
  • Gallbladder pressure increase is a key reflex inhibiting SO activity; its role in pancreatic flow regulation is less studied, but it prevents duodenal reflux.

Conclusions:

  • The sphincter of Oddi (SO) is confirmed as a true sphincter with significant roles in biliary and pancreatic outflow regulation and prevention of duodenal reflux.
  • Understanding the SO's intricate physiological control is essential for diagnosing and managing biliary and pancreatic diseases.
  • Further research is needed to fully elucidate the SO's role in pancreatic flow and its dysfunction in various pathologies.

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