Gastroenterologia Japonica

, Volume 12, Issue 3, pp 209–217 | Cite as

Intraoperative measurement of the bile flow resistance in the terminal portion of the common bile duct and its clinical significance in biliary surgery

  • Tohji Tomita
  • Minora Uekusa
Original Article


A practical method, safe and relatively simple to perform, which we have developed for the intra-operative measurement of the resistance to bile flow in the terminal portion of the common bile duct is described. This method performed routinely in conjunction with the operative cholangiography in the operating room, proved to be a powerful diagnostic aid for detecting abnormalities in the terminal portion of the common bile duct. In gallstone disease, the results by this method were compared with the operative results. It was found that minimal organic changes or functional disturbances in the terminal portion of the common bile duct, even those without jaundice, can be detected, and unnecessary choledochotomy or sphincteroplasty avoided. This method has a further advantage in that it gives universality to the resistance R and the residual pressure P as quantitative discriptive indices for the qualitative state of bile flow in the terminal portion of the common bile duct, and, if adopted as a standard and routine method, should make the comparison of works by different investigators easier and more significant.

Key Words

bile flow resistance cholangiomanometry sphincteroplasty choledochotomy sphincter of Oddi 


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  1. 1).
    Cattell RB, Colcock BP, Pollack JL: Stenosis of the sphincter of Oddi. N Engl J Med 256: 429, 1957CrossRefPubMedGoogle Scholar
  2. 2).
    Judd ES, Mann FC: The effect of removal of the gallbladder: An experimental study. Surg Gynecol Obstet 24: 437, 1917Google Scholar
  3. 3).
    McGowan JM, Butsch WL, Walters W: Pressure in the common bile duct of man. JAMA 106: 2227, 1936CrossRefGoogle Scholar
  4. 4).
    Doubilet H, Colp R: Resistance of the sphincter of Oddi in the human. Surg Gynecol Obstet 64: 622, 1937.Google Scholar
  5. 5).
    Besançon F, Pironneau A, Lopes-Macedo L, Longuet YJ, Debray C: Technique nouvelle et simple d’exploration opératoire du cholédoque: Le débit-mètre à flotteur perfusé sous pression et élevée. Arch Mal Appar Diag 54: 59, 1965Google Scholar
  6. 6).
    Brücke H: Physikalische Messmethoden in der Gallenchirurgie. Langenbecks Arch Klin Chir 321: 334, 1968CrossRefGoogle Scholar
  7. 7).
    Lempke RE: Sphincter of Oddi and gallbladder function. Ann Surg 158: 9, 1963CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8).
    Schein CJ, and Beneventano TC: Biliary manometry: Its role in clinical surgery. Surgery 67: 255, 1970PubMedGoogle Scholar
  9. 9).
    Scott GW, Smallwood RE, Rowlands S: Flow through the bile duct after cholecystectomy. Surg Gynecol Obstet 140: 912, 1975PubMedGoogle Scholar
  10. 10).
    White TT, Waisman H, Hopton D, Kavlie H: Radiomanometry flow rates, and cholangiography in the evalution of common bile duct disease. Am J Surg 123: 73, 1972CrossRefPubMedGoogle Scholar
  11. 11).
    Newman HF, Northup JD: Hydrodynamics of the human common duct. Surg. Gynecol Obstet 105: 355, 1957PubMedGoogle Scholar
  12. 12).
    Boulter PS: Flow studies on the human common duct. Br J Surg 47: 17, 1961CrossRefGoogle Scholar
  13. 13).
    Braasch JW, McCann JC: Normal luminal size of choledochoduodenal junction as determined by probe at choledochostomy. Surgery 62: 258, 1967Google Scholar
  14. 14).
    Reynolds BM: Immediate effects of instrumental dilatation of the ampulla of vater. Ann Surg 164: 271, 1966CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© The Japanese Society of Gastroenterology 1977

Authors and Affiliations

  • Tohji Tomita
    • 1
    • 2
  • Minora Uekusa
    • 1
  1. 1.Department of Surgery, School of MedicineKeio UniversityTokyoJapan
  2. 2.Department of SurgeryNational Tochigi HospitalUtsunomiyaJapan

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