Anton Vavrečka
The functional disorders of the biliary tract (dysfunctions, respectively dyskinesia) are discussed when certain symptoms appear, the most commonly biliary dyspepsia without presence of organic changes. Etiological factors are not sufficiently clarified; dysfunction of gallbladder and/or sphincter of Oddi, or failure of coordination between the activities of the gallbladder and sphincter of Oddi are assumed. The gallbladder dysfunctions include hyperkinetic gallbladder (often with adenomatosis) and hypokinetic gallbladder (etiological factor for gallstones). Dysfunctions of Oddi sphincter can be either organic stenosis, or net movement disorders (dyskinesia). Clinically, biliary dysfunctions are manifested as subcostal or epigastric pain, nausea, sometimes vomiting, and sensitivity to palpation. Diagnosis is based on exclusion of organic diseases of the biliary tract, gastrointestinal tract and other organs. Special diagnostic methods are dynamic ultrasonography, scintigraphy, ERCP, sphincter of Oddi manometry and other specialized tests. In the treatment there were tested prokinetics, calcium channel blockers, nitrates, spasmolytics, analgesics, usually without a significant success. In the sphincter of Oddi disorders the endoscopic treatment may help. Exceptionally a surgical treatment may also come into account.