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Endoscopic measurement using special made microtransducer (4Fr) of pancreatic ductal pressure was performed in the patients with chronic pancreatitis. And at the same time, pure pancreatic juice was collected by endoscopic cannulation on the basal secretory state and the viscosity was measured by microviscosimeter (Brookfield Co. Ltd).There are no significant differences between the systolic papillary pressure (106.3±74.5mmHg) in the normal subjects (n=14) and that (132.8±68.4mmHg) in the patients with chronic pancreatitis (n=14). The pancreatic ductal pressure in the patients with chronic pancreatitis (65.7 ± 31.2mmHg) was significantly higher than that in the normal subjects (18.1 ± 8.6mmHg). The viscosity of pure pancratic juice in the patients with chronic pancreatitis (mean value=2.62cP) was significantly higher than that in the normal subjects (mean value=1.72cP). As in the minimal chronic pancreatitis without dilatation of main pancratic duct the pancreatic ductal pressure was higher than that in the normal subjects, so the mechanism was suggested that the dilatation of main pancreatic duct may be due to the increased ductal pressure in the patients with chronic pancreatitis.After injection of secretin, the pressure in the patients with chronic pancreatitis was decreased by 47% on average and by 28% in the normal subjects. In a patient with papillitis, after injection of secretin the pressure was increased by 20%.Conclusively, the increase in pancreatic ductal pressure in the patients with chronic pancreatitis may be not derived from papillary dysfunction but from high viscosity of pancreatic juice and unknown factors.
- 財団法人 日本消化器病学会の論文
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