胆石成因复杂，Oddi括约肌（SO）异常与其形成关系密切。对于原发胆管色素结石，经十二指肠镜及钡餐检查均发现较高的乳头周围憩室发生率。经T管窦道测压提示SO功能下降，通过口服99mTC-DTPA的方法及检测胰淀粉酶-1和肠激酶含量证实了肠胆反流和胰胆反流的存在。胆石中脂肪酸的测定亦提示细菌产生的磷脂酶A1在胆管色素结石形成中起作用；对于胆囊胆固醇结石，亦存在SO收缩亢进或者张力过高之现象。胆囊切除术后综合征中的SO异常及胆囊切除术后再发胆管结石的现象从一个侧面揭示某些病人的胆囊结石原本是由于SO异常引起。

Correlation between Oddi’s sphincter abnormality and cholelithiasis        WU Shuo-dong. Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
Abstract     The etiology of cholelith is complicated with involvement of sphincter of Oddi(SO). For primary bile duct pigment stones, both duodenoscopy and barium meal revealed high incidence of periampullary diverticulum. SO manometry through “T” tube sinus showed hypomotiligy of SO. Oral intake of 99Tcm-DTPA and measurement of amylopsin-1 and enterokinase confirmed the existence of duodeno-biliary and pancreaticobiliary refluxes. Measurement of fatty acids in gallstones also suggested phospholipase A1 played a role in the formation of bile duct pigment stones. For gallbladder cholesterol stones, hypermotiligy of SO existed. SO dysfunction and recurrent of bile duct stones after cholecystectomy revealed, at least in part, some gallbladder stones were primarily caused by SO abnormality.