ACTION OF CHOLECYSTOKININ-OCTAPEPTIDE ON SPHINCTER OF ODDI BASAL PRESSURE AND PHASIC WAVE ACTIVITY IN HUMANS

  • 1 January 1982
    • journal article
    • research article
    • Vol. 92  (3) , 497-503
Abstract
The human sphincter of Oddi (SO) exhibits phasic wave activity over a 4-6 mm segment. Approximately 60% of these waves occur in an antegrade direction, 14% are retrograde and 26% occur simultaneously. Because cholecystokinin-octapeptide (CCK-OP) stimulates the bile flow into the duodenum, its effect on SO phasic wave contractions and contraction sequences was evaluated at ERCP [endoscopic retrograde cholangiopancreatographic] manometry. An infused triple-lumen catheter of 1.7 mm outer diameter with side orifices spaced 2 mm apart was stationed in the SO segments so that all 3 orifices recorded phasic pressure waves. Thirty-one patients with normal ductal anatomy and normal SO pressures were studied. In 21 of these patients CCK-OP (20 ng/kg) was given i.v. after a 2- to 3-min baseline recording was obtained. Pressure recordings were continued for up to 10 min following CCK-OP administration. CCK-OP caused a significant inhibition in the frequency and amplitude of SO phasic waves, as well as a significant decrease in basal SO pressure. Before CCK-OP, most phasic contractions were antegrade and after CCK-OP the sequence pattern remained unchanged. CCK-OP definitely reduces or transiently abolishes SO phasic contractions, it apparently does not change their temporal sequence. CCK-OP produces a decrease in basal SO pressure. The action of CCK-OP in humans is probably to inhibit SO phasic activity and reduce SO basal pressure to allow increased bile flow.