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Frequency of Papillary Dysfunction Among Cholecystectomized Patients

Authors

  • Simon Bar-Meir,

    Corresponding author
    1. Department of Gastroenterology, Ichilov Hospital and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
    • Simon Bar-Meir, M.D., Department of Gastroenterology, The Edith Wolfson Hospital, Holon 58100, Israel.
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  • Zamir Halpern,

    1. Department of Gastroenterology, Ichilov Hospital and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Eithan Bardan,

    1. Department of Gastroenterology, Ichilov Hospital and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Tuvia Gilat

    1. Department of Gastroenterology, Ichilov Hospital and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Abstract

Four hundred and fifty-four consecutive patients who had had their gallbladder removed were interviewed to determine the presence of upper abdominal pain, increased serum alkaline phosphatase and/or serum amylase activity. Patients with unexplained upper abdominal pain and/or enzyme abnormalities were offered endoscopic retrograde cholangiopancreatography (ERCP) and manometric evaluations. Dysfunction of the sphincter of Oddi diagnosed by ERCP manometry may account for the abdominal pain seen in 14% of the patients with postcholecystectomy syndrome. It may rarely be the cause of an elevated serum alkaline phosphatase and/or amylase when abdominal pain is not present. Papillary dysfunction is seen in less than 1% of the patients who have had their gallbladders removed. ERCP manometry is recommended in cholecystectomized patients with unexplained abdominal pain suggesting pancreaticobiliary origin.

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Ancillary