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Year 2011 Vol. 19 No 6

HYPOTHESISES

M.D. LEVIN, G. MENDELSON, Z. KORSHUN

SPHINCTER OF ODDI AND ITS ROLE IN THE PATHOGENESIS OF THE BILE-PANCREATIC AREA DISEASES

Based on the analysis of literature and our own research the hypothesis of the dysfunction of sphincter of Oddi (DSO) is suggested. DSO is the reaction of the sphincter in response to dyskinesia of the duodenum. It is expressed in a periodic increase pressure in the duodenal segment, in which the sphincter of Oddi opens. Dyskinesia of the duodenum develops in excessive amounts of hydrochloric acid, chronic constipation, colitis, etc. DSO is the cause of biliary dyskinesia, formation of the stones and development of chronic pancreatitis. DSO deteriorated over time. Initial increase in SO pressure gradually transitions into insufficiency. At both high and low pressure of SO conditions are provided for the reflux of duodenal contents into the ducts. The sphincter of Oddi dysfunction may be part of a more generalized motility disorder of the gastrointestinal tract and, therefore, targeting to the SO only is not the solution to problem. A practical conclusion that follows is: if you have to remove the gallbladder, you need to find the cause of DSO and solve the problem without waiting for the appearance of post cholecystectomy symptoms.

Keywords: sphincter of Oddi, pathophysiology, dyskinesia of the bile ducts, digestive tract functional diseases, duodenum, diverticula
p. 139 - 145 of the original issue
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