[Pressure-diameter-relationship of the papilla duodeni. An experimental study (author's transl)]

[Intraoperative mural pressure measurements in the papilla of Vater (author's transl)]

The mural pressure in the papilla of Vater was measured in fifteen patients with benign stenosis of the papilla of Vater and in fifteen patients with normal papillary function by intraoperative water manometry. There was a zone of high pressure in the papilla of a few millimeters. The mural pressure in normal papillary function ws much higher than in papillary stenosis. There was only a tiny difference of pressure in functional and in fibrotic stenoses. Functional stenoses showed a non-linear pressure-diameter relationship when extended by probes of increasing diameter. Fibrotic stenoses could not be probed or could only be probed minimally. It is concluded that high mural pressures in the papilla of Vater do not represent pathologic papillary function. Functional and fibrotic stenoses can only be differentiated by probing.

[Is the duodenal papilla an autonomic sphincter? A contribution to the functional morphology (author's transl)]

A morphologic study of the duodenal papilla was performed by laminations in three planes. The muscle system reveals that there are no autonomic sphincters, but muscle bundles deriving from duodenal longitudinal and circular muscle layers, interdigitating and acting for opening of the papillary mouth. Activity results from myogenous rhythmic contractions of smooth muscle cells, stimulated by the ductal hydrostatic pressure, and from the duodenal peristalsis. The closure of the papilla is weak, incomplete and achieved by the oblique entrance of the duct. Interpretation of functional analysis and procedures of treatment should be based upon the knowledge of normal morphology of the papilla.