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Biliary dyskinesia: role of the sphincter of Oddi, gallbladder and cholecystokinin.

Abstract
The availability of objective and quantitative diagnostic tests in recent years has allowed more precise documentation of biliary dyskinesia. Biliary dyskinesia consists of two disease entities situated at two different anatomical locations: sphincter of Oddi spasm, at the distal end of the common duct, and cystic duct syndrome, in the gallbladder. Both conditions are characterized by a paradoxical response in which the sphincter of Oddi and the cystic duct contract (and impede bile flow) instead of undergoing the normal dilatation, when the physiological dose of cholecystokinin is infused. Quantitative cholescintigraphy can clearly differentiate one disease entity from the other. The therapies of choice are sphincterotomy, sphincteroplasty or antispasmodics for sphincter of Oddi spasm and cholecystectomy for cystic duct syndrome. After quantitative cholescintigraphy, the final impression should identify the disease entity by name to assist the referring physician in making an appropriate therapeutic decision; a mere statement that a test is consistent with biliary dyskinesia is no longer sufficient.
AuthorsS Krishnamurthy, G T Krishnamurthy
JournalJournal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 38 Issue 11 Pg. 1824-30 (Nov 1997) ISSN: 0161-5505 [Print] United States
PMID9374365 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Review)
Chemical References
  • Aniline Compounds
  • Imino Acids
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Cholecystokinin
  • technetium Tc 99m mebrofenin
  • Glycine
Topics
  • Aniline Compounds
  • Biliary Dyskinesia (diagnostic imaging, physiopathology)
  • Cholecystokinin (physiology)
  • Common Bile Duct Diseases (diagnostic imaging, physiopathology)
  • Cystic Duct (physiopathology)
  • Gallbladder (physiopathology)
  • Glycine
  • Humans
  • Imino Acids
  • Organotechnetium Compounds
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Sphincter of Oddi (physiopathology)

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