The dynamic observatory method of function of the choledochoduodenal junction: its clinical application in the surgery of the biliary tract

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In the recent years many studies have been done about bile flow at the distal portion of the common duct. And those studies give us many informations about understanding the disease itself and are important for a successful operation on the biliary tract.We have studied the subjects for five years by our method. By it's results we make a decision, whether additional procedure on it after cholecystectomy is neccesary or not.Principle of our manometry, different from Caroli's or Mallet-Guy's, is that the varing irrigation pressure changes flow volume of the distal portion. This relationship between them is a certain straight line on the graphic registration. This inclination of the line is calculated as a resistant value. Irrigation pressure at the zero point of the flow volume, we call it"P"value. The relatinship between these two values is investigated and finally accepted the following situations about the choledochoduodenal junction. The subjects with both high values are classified as the functional hypercondition. The subjects with both low values are classified as the organic hypotonic condition. The subjects with high resistant value and low"P"value are classified as the organic stricture.The analysis was made for 200 subjects of benign biliary tract disease and normal ranges are determined as below 20 for the resistant value and as 50 to 150mm H2O for "P" value.The surgical approach to the biliary tract, especially to the distal portion of the common duct, is determined for the subjects with exceeding these normal ranges, referring the findings of the operative cholangiography.These results have been satisfactory up to the present time.
財団法人日本消化器病学会の論文

The dynamic observatory method of function of the choledochoduodenal junction: its clinical application in the surgery of the biliary tract

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