- 3509 N. Broad St.
Boyer Pavilion, E938
Philadelphia, PA 19140 - 215-707-0996
Henry Pitt
Temple University School of Medicine, Department of Surgery, Faculty Member
- Henry A. Pitt, M.D. completed his surgical training at Johns Hopkins in 1979. He spent the next six years at UCLA as ... moreHenry A. Pitt, M.D. completed his surgical training at Johns Hopkins in 1979. He spent the next six years at UCLA as an Assistant Professor working with William P. Longmire, Jr. In 1985, he returned to Johns Hopkins as Vice Chairman of Surgery and helped to develop one of the premier HPB (hepato-pancreato-biliary) surgical programs in the United States. During this time, Dr. Pitt was the President of the Society of Clinical Surgery. In 1997 he moved to the Medical College of Wisconsin as the Chairman of Surgery. While in Milwaukee, he was president of the Americas Hepato-Pancreato-Biliary-Association (AHPBA). In 2004 he moved to Indiana University (IU) where he initiated the HPB Surgery Fellowship, became the Chief Quality Officer of IU Hospital and was President of the International-Hepato-Pancreato-Biliary-Association (IHPBA). In 2013 Dr. Pitt became the Chief Quality Officer for the Temple University Health System. In 2014 Dr. Pitt developed an HPB Collaborative of more than 80 hospitals in four countries for the American College of Surgeons-National Surgical Quality Improvement Program. He has received the HPB Medallion from the IHPBA and the Distinguished Service Award for the AHPBA. Dr. Pitt is a Fellow of the Royal College of Surgeons in Edinburgh and an Honorary Professor of three medical schools in China. He has served on multiple editorial boards and has published more than 450 peer-reviewed articles as well as 125 book chapters, and he has edited 18 books.edit
Objective: To establish the association between bactibilia and postoperative complications when stratified by perioperative antibiotic prophylaxis. Background: Patients undergoing pancreatoduodenectomy experience high rates of surgical... more
Objective: To establish the association between bactibilia and postoperative complications when stratified by perioperative antibiotic prophylaxis. Background: Patients undergoing pancreatoduodenectomy experience high rates of surgical site infection (SSI) and clinically relevant postoperative pancreatic fistula (CR-POPF). Contaminated bile is known to be associated with SSI, but the role of antibiotic prophylaxis in mitigation of infectious risks is ill-defined. Methods: Intraoperative bile cultures (IOBCs) were collected as an adjunct to a randomized phase 3 clinical trial comparing piperacillin-tazobactam with cefoxitin as perioperative prophylaxis in patients undergoing pancreatoduodenectomy. After compilation of IOBC data, associations between culture results, SSI, and CR-POPF were assessed using logistic regression stratified by the presence of a preoperative biliary stent. Results: Of 778 participants in the clinical trial, IOBC were available for 247 participants. Overall, 68 (27.5%) grew no organisms, 37 (15.0%) grew 1 organism, and 142 (57.5%) were polymicrobial. Organisms resistant to cefoxitin but not piperacillin-tazobactam were present in 95 patients (45.2%). The presence of cefoxitin-resistant organisms, 92.6% of which contained either Enterobacter spp. or Enterococcus spp., was associated with the development of SSI in participants treated with cefoxitin [53.5% vs 25.0%; odds ratio (OR)=3.44, 95% CI: 1.50–7.91; P=0.004] but not those treated with piperacillin-tazobactam (13.5% vs 27.0%; OR=0.42, 95% CI: 0.14–1.29; P=0.128). Similarly, cefoxitin-resistant organisms were associated with CR-POPF in participants treated with cefoxitin (24.1% vs 5.8%; OR=3.45, 95% CI: 1.22–9.74; P=0.017) but not those treated with piperacillin-tazobactam (5.4% vs 4.8%; OR=0.92, 95% CI: 0.30–2.80; P=0.888). Conclusions: Previously observed reductions in SSI and CR-POPF in patients that received piperacillin-tazobactam antibiotic prophylaxis are potentially mediated by biliary pathogens that are cefoxitin resistant, specifically Enterobacter spp. and Enterococcus spp.
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Research Interests: Endocrinology, Enzyme Inhibitors, Medicine, Western blotting, Humans, and 15 moreInternal Medicine, Nitric oxide, Female, Animals, Acetylcholine, Sciuridae, Clinical Sciences, Nitric Oxide Synthase, Vasoactive Intestinal Peptide, Stimulation, Iron Deficiency Anemia, Ileum, Down-Regulation, Gastrointestinal surgery, and Electric stimulation
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The clinical importance of postoperative hyperamylasemia (POHA) grade is unknown. Our objectives were to evaluate the association of POHA grade with clinically relevant postoperative pancreatic fistula (CR-POPF) and compare its prognostic... more
The clinical importance of postoperative hyperamylasemia (POHA) grade is unknown. Our objectives were to evaluate the association of POHA grade with clinically relevant postoperative pancreatic fistula (CR-POPF) and compare its prognostic utility against postoperative day 1 drain fluid amylase (DFA-1). Patients who underwent pancreatectomy from January 2019 through March 2020 were identified in the ACS NSQIP pancreatectomy-targeted dataset. POHA grade was assigned using post-operative serum amylase and clinical sequelae. The primary outcome was CR-POPF within 30 days. The association of POHA grade with CR-POPF was assessed using multivariable logistic regression, and c-statistics were used to compare POHA grade versus DFA-1. POHA occurred in 520 patients at 98 hospitals, including 261 (50.2%) with grade A, 234 (45.0%) with grade B, and 25 (4.8%) with grade C POHA. CR-POPFs were increased among patients with grade B (66.2%, OR 9.28 [5.84-14.73]) and C (68.0%, OR 10.50 [3.77-29.26]) versus grade A POHA (19.2%). POHA-inclusive models better predicted CR-POPF than those with DFA-1 alone (p < 0.002) and models with both predictors outperformed POHA alone (p = 0.039). POHA grade represents a measure of post-pancreatectomy outcomes that predicts CR-POPF and outperforms DFA-1 but must be aligned with new international definitions.
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We have previously described a cholecysto-sphincter of Oddi reflex whereby sphincter of Oddi (SO) motility is mediated in part by the degree of gallbladder distension. Therefore, we tested the hypothesis that cholecystectomy alters the... more
We have previously described a cholecysto-sphincter of Oddi reflex whereby sphincter of Oddi (SO) motility is mediated in part by the degree of gallbladder distension. Therefore, we tested the hypothesis that cholecystectomy alters the response of the SO to endogenous and exogenous hormonal stimulation. Eight months after sham laparotomy (n = 8) or cholecystectomy (n = 10), prairie dogs were anesthetized with alpha-chloralose. The common bile duct was cannulated distally with a side-hole, pressure-monitored catheter perfused with degassed water at 0.15 ml/min. The duodenum was cannulated distal to the SO to allow perfusion of the proximal 30 cm of intestine with 20 mmol/L sodium oleate at 0.4 ml/min. In animals undergoing sham laparotomy the gallbladder was cannulated, aspirated, and kept empty throughout the experiment. SO phasic wave frequency (F), amplitude (A), and baseline pressure were measured for 60 minutes before and during intraduodenal (ID) perfusion of sodium oleate and then for 60 minutes before and 30 minutes during intravenous (IV) infusion of cholecystokinin-octapeptide (CCK-OP) at 10 ng/kg/min. A SO motility index (MI) (MI = F X A) was calculated for each 10-minute period. Common duct diameter and resting SO motility were unaltered 8 months after cholecystectomy. In animals that had sham laparotomy ID infusion of sodium oleate reduced SO MI by 46% (p = 0.06) and 75% (p less than 0.05) at 30 and 60 minutes, respectively, whereas in animals that had cholecystectomy the reduction in SO MI was only 6% and 25% (p less than 0.05) during the same periods. In animals that had sham laparotomy IV CCK-OP increased the SO MI by 175% (p less than 0.05), but in the animals that had cholecystectomy IV CCK-OP increased SO MI by only 60% (no significance). These findings indicate that after cholecystectomy resting SO motility is unaltered, but the response to ID sodium oleate and to IV cholecystokinin is blunted. We suggest that cholecystectomy alters neural pathways that mediate the normal response of the SO to endogenous and exogenous hormonal stimulation.
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Background/aim: This article will examine the current role of preoperative biliary drainage by reviewing risk factors in the jaundiced patient, the results of retrospective and prospective studies of preoperative biliary decompression,... more
Background/aim: This article will examine the current role of preoperative biliary drainage by reviewing risk factors in the jaundiced patient, the results of retrospective and prospective studies of preoperative biliary decompression, and present indications for preoperative biliary drainage. Materials and methods: We reviewed 26 articles published between 1934 and 1994. Results: Information on the following topics is presented: Morbidity and Mortality, Risk Factors, Retrospective Studies, Prospective Randomized Studies, Internal Biliary Drainage, Preoperative Biliary Drainage in the Malnourished Patient, Preoperative Biliary Drainage for Cholangitis, Preoperative Biliary Drainage as a Technical Aid, and Preoperative Biliary Drainage Before Liver Resection. Conclusions: While the routine use of preoperative biliary drainage can not be recommended, it may be indicated in certain clinical situations. In a selected subset of patients who are severely malnourished or are suffering from acute suppurative cholangitis preoperative drainage may be beneficial. Finally, preoperative placement of biliary catheters may be a useful technical aid in patients requiring a difficult hilar dissection for proximal biliary diseases.
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Research Interests: Computed Tomography, Medicine, Humans, Low Dose, Female, and 15 moreMale, Interventional Radiology, Acute Pancreatitis, Length of Stay, Clinical Sciences, Aged, Middle Aged, Gold Standard, Medical Image, Adult, Background Radiation, Ionizing Radiation, Effective Dose, Magnetic resonance image, and Gastrointestinal surgery
Pancreatic cancer is the fifth leading cause of cancer death in the United States, with an overall survival rate of 3%. Unfortunately, only a minority of patients present with localized disease amenable to surgical resection. Over the... more
Pancreatic cancer is the fifth leading cause of cancer death in the United States, with an overall survival rate of 3%. Unfortunately, only a minority of patients present with localized disease amenable to surgical resection. Over the past 20 years, improvements in operative and perioperative management have led to a decrease in operative mortality, shorter hospital stay, and overall 5-year survival of approximately 20% in patients undergoing pancreaticoduodenectomy. Despite advances in nonoperative palliation, surgery continues to play an important role in the management of patients with locally advanced, unresectable pancreatic cancer.
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THE NEED to improve the reporting of the results of various therapeutic maneuvers designed to relieve the pain and rectify the complications of chronic pancreatitis has long been recognized. 1 Factors considered important in assessing the... more
THE NEED to improve the reporting of the results of various therapeutic maneuvers designed to relieve the pain and rectify the complications of chronic pancreatitis has long been recognized. 1 Factors considered important in assessing the efficacy of these therapeutic interventions include the ease and safety of their use, the completeness and duration of the pain relief they induce, the incidence and severity of any physiological impairments they produce (such as endocrine and exocrine insufficiency), their associated morbidity and mortality, and their impact on the length and quality of life. Over the past 10 years, there has been some general improvement in the details provided by surgeons reporting the results of operations performed to relieve the pain of chronic pancreatitis. It has become standard to specify the length of follow-up, the incidence of postoperative exocrine and endocrine insufficiency, and change in weight and work status when reporting the operative results
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Aging is one of the least clearly understood biological processes. Alteration of oxidation/reduction (redox) enzymes has been demonstrated with aging; however, a systematic analysis of expression patterns has not been performed. The liver... more
Aging is one of the least clearly understood biological processes. Alteration of oxidation/reduction (redox) enzymes has been demonstrated with aging; however, a systematic analysis of expression patterns has not been performed. The liver plays a key role in homeostasis and detoxification; therefore alteration of hepatic gene expression with aging may affect outcome after surgery. The purpose of our study was to assess changes in gene expression patterns in aged livers from both rats and humans using gene array analysis. Total RNA was extracted from young (2-month-old) and aged (2-year-old) rat livers, as well as young (1-year-old) and aged (78-year-old) human livers. Gene expression patterns were compared using Affymetrix GeneChip arrays. The expression pattern of selected genes was confirmed by reverse transcription-polymerase chain reaction. A threefold or greater change in gene expression was noted in 582 genes in the aged rat livers and 192 genes in the aged human livers. Comparison of the genes that were increased with aging demonstrated some similar patterns of expression in the rat and human livers, particularly in members of the antioxidant family and the cytochrome P-450 genes. Our findings demonstrate changes in the expression pattern of genes in the liver with aging. Concomitant increases in the expression of important antioxidant and detoxifying genes were noted in the livers of both rats and humans. This induction pattern suggests a complex link between changing hepatic detoxification/redox capability and senescence.
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ObjectiveThe aim of this study was to determine if a significant genetic component contributes to the pathogenesis of symptomatic gallstones.Summary Background DataGallstones represent a polygenic disorder that affects more than... more
ObjectiveThe aim of this study was to determine if a significant genetic component contributes to the pathogenesis of symptomatic gallstones.Summary Background DataGallstones represent a polygenic disorder that affects more than 30,000,000 Americans and results in more than 750,000 cholecystectomies in the United States annually. Risk factors include age, gender, race, parity, obesity, and diabetes. A family history of gallstones also has been identified as a risk factor suggesting that genetics play a role in gallstone formation. However, the role of genetics in the pathogenesis of gallstone formation has not been determined.MethodsA gallbladder disease-specific questionnaire was administered to 904 healthy unrelated adult volunteers (association study). The questionnaire ascertained a history of cholecystectomy and gallstone disease in first-degree relatives, as well as medical history, demographic, and anthropometric data. A logistic regression model was used to identify risk factors for symptomatic gallstone disease in a multivariate analysis. A maximum likelihood based variance decomposition approach was then used in 1,038 individuals from 358 families (family study) to estimate the additive genetic heritability of symptomatic gallstone disease.ResultsIn the association study significant risk factors for symptomatic gallstone disease were female gender (relative risk 8.8, P < .003), obesity (BMI > 30, relative risk 3.7, P < .001), age > 50 (relative risk 2.5, P < .001), and a positive family history of previous cholecystectomy in a first-degree family member (relative risk 2.2, P < .01). In the family study the additive genetic heritability of symptomatic gallstones was 29% (P < .02), age and gender were significant covariates and explained 9.3% of the phenotypic variation in gallbladder disease.ConclusionsThese data suggest that genetic factors are responsible for at least 30% of symptomatic gallstone disease. However, the true role of heredity in gallstone pathogenesis is probably higher because data based on symptomatic gallbladder disease underestimates the true prevalence in the population.
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Research Interests: Gastroenterology, Incidence Geometry, Adolescent, Medicine, Humans, and 15 moreInternal Medicine, Fasting, Gallbladder disease, Female, Disease, Male, Clinical Sciences, Adult, Gallbladder, Neurosciences, Cholelithiasis, Crohn Disease, Cholecystitis, Paediatrics and reproductive medicine, and Ileal diseases
Mucinous cysts of the pancreas represent the most common identifiable precursor to pancreatic cancer. Evidence-based guidelines for screening and surveillance exist, but many patients are either not properly identified or lost to... more
Mucinous cysts of the pancreas represent the most common identifiable precursor to pancreatic cancer. Evidence-based guidelines for screening and surveillance exist, but many patients are either not properly identified or lost to follow-up. Artificial Intelligence, specifically computational linguistics models, can dramatically improve patient identification and mitigate risk through modernizing pancreatic cyst longitudinal surveillance. Herein we discuss the risk associated with mucinous cysts of the pancreas and modern approaches to patient identification and follow-up.
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Objective:To compare the rate of postoperative 30-day complications between laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD).Background:Previous studies suggest that minimally invasive... more
Objective:To compare the rate of postoperative 30-day complications between laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD).Background:Previous studies suggest that minimally invasive pancreaticoduodenectomy (MI-PD)—either LPD or RPD—is noninferior to open pancreaticoduodenectomy in terms of operative outcomes. However, a direct comparison of the two minimally invasive approaches has not been rigorously performed.Methods:Patients who underwent MI-PD were abstracted from the 2014 to 2019 pancreas-targeted American College of Surgeons National Sample Quality Improvement Program (ACS NSQIP) dataset. Optimal outcome was defined as absence of postoperative mortality, serious complication, percutaneous drainage, reoperation, and prolonged length of stay (75th percentile, 11 days) with no readmission. Multivariable logistic regression models were used to compare optimal outcome of RPD and LPD.Results:A total of 1540 MI-PDs were identified between 2014 and 2019, of which 885 (57%) were RPD and 655 (43%) were LPD. The rate of RPD cases/year significantly increased from 2.4% to 8.4% (P=0.008) from 2014 to 2019, while LPD remained unchanged. Similarly, the rate of optimal outcome for RPD increased during the study period from 48.2% to 57.8% (P&lt;0.001) but significantly decreased for LPD (53.5% to 44.9%,P&lt;0.001). During 2018–2019, RPD outcomes surpassed LPD for any complication [odds ratio (OR)=0.58,P=0.004], serious complications (OR=0.61,P=0.011), and optimal outcome (OR=1.78,P=0.001).Conclusions:RPD adoption increased compared with LPD and was associated with decreased overall complications, serious complications, and increased optimal outcome compared with LPD in 2018–2019.
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Research Interests: Quality Improvement, Risk assessment, Medicine, Logistic Regression, Humans, and 15 moreFemale, Male, Risk factors, Aged, Retrospective Studies, Risk Factors, Risk Assessment, Logistic Models, Receiver Operating Characteristic, Confidence Interval, Abdomen, Postoperative Complications, cutoff, Respiratory insufficiency, and Medical and Health Sciences
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Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is frequently performed for suspected biliary tumors for diagnosis and staging but carries a theoretical risk of needle-track seeding. We aimed to evaluate the impact of... more
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is frequently performed for suspected biliary tumors for diagnosis and staging but carries a theoretical risk of needle-track seeding. We aimed to evaluate the impact of preoperative EUS-FNA on long-term outcomes for patients with cholangiocarcinoma (CCA). In a retrospective single-center study of consecutive patients with CCA with preoperative EUS-FNA, main outcome measures were overall survival and progression-free survival. In 150 patients with confirmed CCA, 61 underwent preoperative FNA. Median overall survival was 18.5 months (95% confidence limits [CL] 15.4, 25.7): 111 patients died and 39 survived. Of the 150 patients, 119 underwent curative-intent surgical resection, with median progression-free survival of 17.8 months (95% CL 14.5, 22.8); 89/119 patients had tumor recurrence or died, and 30/119 remained alive and disease-free. On multivariable analysis, overall survival was associated with: undergoing curative-intent surgery (hazard ratio [HR] 5.79, P = 0.001), lack of lymph node involvement (HR 1.89, P = 0.011), younger age (HR 1.51 for every 10 years, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0015), and small tumor size (HR 1.11 for every 1 cm, P = 0.029). For patients undergoing curative-intent surgery, on multivariable analysis, improved progression-free survival was associated with: lack of lymph node involvement (HR 1.88, P = 0.010), smaller tumor size (HR 1.16 for every 1 cm smaller, P = 0.003), and younger age (HR 1.53 for every 10 years, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Number of needle passes showed no statistically significant impact on overall survival. Preoperative EUS-FNA in patients with CCA does not appear to adversely affect overall or progression-free survival.
Research Interests: Medicine, Endoscopy, Multivariate Analysis, Humans, Female, and 15 moreMale, Liver Transplantation, Clinical Sciences, Aged, Middle Aged, Adult, Cholangiocarcinoma, Retrospective Studies, Endoscopic Ultrasound, Lymph Node, Pancreaticoduodenectomy, Postoperative Period, Hepatectomy, Neoplasm staging, and hazard ratio
Gastroenterology, Volume 120, Issue 5, Pages A483, April 2001, Authors:Matthew I. Goldblatt; Jason S. Duelge; Beth A. Erickson; Paul S. Ritch; Michael J. Demeure; Stuart D. Wilson; Henry A. Pitt. Gastroenterology - Click here ...
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Although gallstones and disorders of biliary tract motility are both more common in women than men, sphincter of Oddi motility has not previously been compared between the sexes. In this study, cholescintigraphy (under ketamine and... more
Although gallstones and disorders of biliary tract motility are both more common in women than men, sphincter of Oddi motility has not previously been compared between the sexes. In this study, cholescintigraphy (under ketamine and diazepam anesthesia) was used to determine gallbladder emptying rate and ejection fraction in response to cholecystokinin (CCK) in eight male and six female prairie dogs fed a nonlithogenic diet. Ten days later, under alpha-chloralose anesthesia, sphincter of Oddi phasic wave activity was monitored for 10-min intervals before (control), during 20 min of CCK infusion, and for 20 min after infusion. Gallbladder emptying rate and ejection fraction and baseline sphincter of Oddi frequency, amplitude, and motility index (= frequency x amplitude) did not differ significantly between the sexes. Sphincter of Oddi phasic wave frequency was increased during CCK infusion in both males and females, but the change in amplitude was significantly greater in females, than males. We conclude that the increased incidence of biliary tract disease in women may be due to altered sphincter of Oddi hormonal response.