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Intrabiliary pressure measurement by duodenal pressure loading for the evaluation of duodenal parapapillary
1Second Department of Surgery, School of Medicine, Kanazawa University, Ishikawa, Japan.
Background/Aims:
We report a method of intrabiliary pressure measurement by duodenal pressure loading for evaluating the effects of duodenal parapapillary diverticulum.
Material And Methods:
Forty-eight patients with primary choledocholithiasis were investigated based on usual intrabiliary pressure measurement developed at our department.
Results:
Ten of these patients with parapapillary diverticulum showed higher intrabiliary residual pressure (P) and biliary resistance (R) values than the remaining patients without diverticulum, but the difference were not significant. There were no significant differences in the frequency of patterns of the B zone angulation of the pressure curve between the two groups with and without parapapillary diverticulum. Intrabiliary pressure was measured while maintaining a manometer pressure of 250 mm H2O by infusing or aspirating physiologic saline.
Conclusion:
From the results of this measurement for 6 patients, when P and R values show increases of 50 mm H2O or more and 3.5 units or more, respectively, additional surgery for parapapillary diverticulum was considered to be indicated.