Frequency of papillary dysfunction among cholecystectomized patients

Hepatology. Mar-Apr 1984;4(2):328-30. doi: 10.1002/hep.1840040225.

Abstract

Four hundred and fifty-four consecutive patients who had had their gallbladder removed were interviewed to determine the presence of upper abdominal pain, increased serum alkaline phosphatase and/or serum amylase activity. Patients with unexplained upper abdominal pain and/or enzyme abnormalities were offered endoscopic retrograde cholangiopancreatography (ERCP) and manometric evaluations. Dysfunction of the sphincter of Oddi diagnosed by ERCP manometry may account for the abdominal pain seen in 14% of the patients with postcholecystectomy syndrome. It may rarely be the cause of an elevated serum alkaline phosphatase and/or amylase when abdominal pain is not present. Papillary dysfunction is seen in less than 1% of the patients who have had their gallbladders removed. ERCP manometry is recommended in cholecystectomized patients with unexplained abdominal pain suggesting pancreaticobiliary origin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alkaline Phosphatase / blood
  • Ampulla of Vater / physiopathology*
  • Amylases / blood
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholecystectomy / adverse effects*
  • Common Bile Duct Diseases / enzymology
  • Common Bile Duct Diseases / epidemiology
  • Common Bile Duct Diseases / etiology
  • Female
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Pain / etiology
  • Sphincter of Oddi / physiopathology*

Substances

  • Alkaline Phosphatase
  • Amylases