Biliary pressure variation in coordination with migrating motor complex of duodenum in patients with cholecystectomy and effects of morphine and cerulein

Pressures in the common bile duct and duodenum were continuously measured with two pressure microtransducers placed by endoscopy in 10 postcholecystectomy patients. A complete cycle of the migrating motor complex of the duodenum was obtained in seven patients, its length ranging from 62 to 174 min with a mean of 114 min. The biliary pressure showed a transient elevation of 5.0±0.6 (mean±sem) mm Hg (P<0.001) in concert with phase II of the duodenal cycle in all 10 patients, whereas it remained stable during other phases. Intramuscular morphine (0.2 mg/kg) given to induce spasm of the sphincter of Oddi 20 min after the passage of phase II invariably produced an activity front in the duodenum and a sustained increase in the biliary pressure, the magnitude of which was 8.3±0.9 mm Hg. The biliary pressure raised by morphine dropped after an intravenous injection of cerulein (0.1 g/kg) as a sphincter relaxant. These findings indicate that the biliary pressure rises transiently at phase III of the duodenal cycle in patients after cholecystectomy, probably due to contractions of the sphincter of Oddi.