A DEMONSTRATION OF THE INDEPENDENT CONTRACTION OF THE SPHINCTER OF THE COMMON BILE DUCT IN HUMAN SUBJECTS

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Abstract
5 patients with choledochostomy tubes were studied in a manner permitting kymographic recording of the intraduodenal pressure, the pressure within the common bile duct, and the flow of an infused fluid (saline soln. ) through the bile duct. Disten-tion of the bile ducts by elevation of the infusion flask produced pain. During the time the distention was maintained (60 sec), intermittent periods of increased resistance developed to flow of fluid into the duodenum, and these were associated with intense pain similar to biliary colic. Duodenal motility was not altered by distention of the bile ducts. Since contraction of the duodenal musculature did not play a significant role in obstructing the passage of fluid into the duodenum, and since there is little smooth muscle in the wall of the common bile duct except at its terminal portion, the increased resistance to flow was due apparently to contraction of the sphincter of Oddi independent of the duodenal musculature.