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Dyskineses of biliary ducts - etiopathogenesis, clinical course, diagnosis and treatment

Danuta Owczarek, Dariusz Skulina, Irena Ciećko-Michalska, J—ózef Bogdał

Med Sci Monit 1999; 5(5): RA1020-1023 :: ID: 503446

Abstract

Dyskinesias of biliary ducts are disturbances of motorial activity and tone of the gallbladder, bile tracts and Oddi's sphincter. The correct function of the system of biliary ducts depends on maintaining proper pressure in it and this pressure, in turn, depends appreciably on the function of the gallbladder itself. Tone, compliance and elasticity of duct tract walls should be constantly maintained in harmony. The motor activity is controlled by hormonal, nervous and mechanical stimuli. Dyskineses of biliary ducts are cause to the occurrence of a series of clinical symptoms that do not differ from the symptoms of organic diseases of this system. Before diagnosing 'Dyskinesis biliaris ', first of all organic diseases must be excluded. A cause to dyskinesis of the gallbladder, biliary ducts and Oddi's sphincter can be post-inflammatory fibrosis, changed function of smooth muscles, of their autonomous innervation as well as pathological reaction to hormonal, nervous and mechanical stimuli. Disturbances in the function of the gallbladder lead to its hypotonia, hypertonia, hypo- or hyperkinesis. As far as Oddi's sphincter is concerned, there can be distinguished two types of disfunctions: stenotic and dyskinetic. The treatment of dyskinesis biliaris consist in applying a diet and pharmacotherapy. Although the surgical treatment of some dysfunctions of biliary ducts is controversial, in some cases good results are attained, for example in the case of sphincterotomy in patients whose choledochus has a diameter over 12 mm or of cholecystostomy in patients with the gallbladder ejection fraction under 35%. Then, there have also been some attempts at treating dyskineses with sound waves or laser irradiation.

Keywords: treatment, dyskineses odiagnosis, clinicals, dyskineses of biliary ducts, Diagnosis

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750