The gallbladder after endoscopic papillotomy

The extrahepatic part of the biliary system plays an important role in the storage of bile and its transport to the intestine. The gallbladder and the sphincter of Oddi regulate these functions both actively and passively. We have learned that the gallbladder fills when it is empty, and the closed sphincter of Oddi causes the pressure in the common bile duct to increase over the pressure within the gallbladder1. But after endoscopic papillotomy (EPT), we have observed patients with a wide open sphincter of Oddi and aerobilia whose gallbladder fills after intravenously administered contrast medium2. So, after EPT the gallbladder is not always a backwater for bile flow. Following EPT, potentially life threatening complications, for some patients, may originate here.