胆道末端部の機能診断―内視鏡的直視下導出法による乳頭部筋電図を中心に

Functional Diagnosis of the Terminal Choledochus: Endoscopic Electromyography of the Papilla of Vater

　近年，消化管の形態学的診断の発達は目覚ましく，これと並行して消化管機能検査法にも新しい展開が生まれつつある．しかし，消化管の機能検査法はその目的・手技に応じて対象選定や精度検定など多くの検討項目を有するだけに，一般臨床の場に広く定着するまでには至っていない．われわれはこれまで幾つかの機能検査法を駆使して，消化管各臓器へのアプローチに取り組んできた^1)～4)．本稿ではこのうち胆道末端部の機能診断について述べる．

　To make a functional diagnosis of the terminal part of the choledochus, we tried a clinical application of endoscopic electromyography of the papilla of Vater. Although the method has remained to have only supplementary role on morphological diagnosis at the present time, we have to contrive it to be able to make a functional diagnosis on minor pathophysiological change of the terminal choledochus by improving its accuracy or combining with several other functional examinations.

　Using the same patient as materials, we could so far applied our method to analyze physiological change of the papilla of Vater by performing its continuous motility study or to evaluate therapeutic efficacy on the operative procedure such as endoscopic sphincterotomy.