Frequency of abnormal biliary and pancreatic basal sphincter pressure at sphincter of Oddi manometry (SOM) in 593 patients

Damian Eversman, Stuart Sheiman, Lois Bucksot, Dee Earle, Michael Rusche, Klaus Gottlieb, Glen Lehman

Research output: Contribution to journalArticle

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Abstract

Sphincter of Oddi dysfunction can be fully classified and detected only if both the pancreatic and biliary portions of the sphincter are simultaneously studied. METHODS: From 1993-6, SOM was successfully performed on both the pancreatic and bile ducts in 593 patients who had idiopathic pancreatitis or pain suggestive of a pancreatobiliary origin. One to three station pull throughs were done in each duct using the Wilson-Cook aspirating triple lumen catheter perfused at .25 ml/min/lumen. The basal sphincter pressure was determined for each lead and averaged for all pull throughs for that duct. A basal sphincter pressure ≥ 40 mmHg was considered abnormal. Phasic waves were not tallied. RESULTS: ABNORMAL BASAL SPHINCTER PRESSURE (%) Prior Sphincter Therapy Pancreas Alone Biliary Alone Both Total Yes (n=232) 87 (37%) 1 (.5%) 20 (9%) 108 (47%) No (n=360) 68 (19%) 41 (11%) 113(31%) 222 (62%) SUMMARY: 1) Basal sphincter pressure abnormalities are present at SOM in more than one-half of thoroughly studied patients in our ERCP unit. 2) Concordance between biliary and pancreatic (both normal or abnormal) basal sphincter pressure for previously untreated patients was 70%. 3) After biliary sphincterotomy, symptomatic patients have a high frequency of pancreatic basal sphincter abnormalities. CONCLUSION: Both pancreatic and biliary portions of the sphincter of Oddi must be evaluated to fully define sphincter dysfunction.

Original languageEnglish (US)
Pages (from-to)AB131
JournalGastrointestinal endoscopy
Volume45
Issue number4
DOIs
StatePublished - Jan 1 1997

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Sphincter of Oddi
Manometry
Pressure
Sphincter of Oddi Dysfunction
Endoscopic Retrograde Cholangiopancreatography
Pancreatic Ducts
Bile Ducts
Pancreatitis
Pancreas
Catheters
Pain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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Frequency of abnormal biliary and pancreatic basal sphincter pressure at sphincter of Oddi manometry (SOM) in 593 patients. / Eversman, Damian; Sheiman, Stuart; Bucksot, Lois; Earle, Dee; Rusche, Michael; Gottlieb, Klaus; Lehman, Glen.

In: Gastrointestinal endoscopy, Vol. 45, No. 4, 01.01.1997, p. AB131.

Research output: Contribution to journalArticle

Eversman, Damian ; Sheiman, Stuart ; Bucksot, Lois ; Earle, Dee ; Rusche, Michael ; Gottlieb, Klaus ; Lehman, Glen. / Frequency of abnormal biliary and pancreatic basal sphincter pressure at sphincter of Oddi manometry (SOM) in 593 patients. In: Gastrointestinal endoscopy. 1997 ; Vol. 45, No. 4. pp. AB131.
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abstract = "Sphincter of Oddi dysfunction can be fully classified and detected only if both the pancreatic and biliary portions of the sphincter are simultaneously studied. METHODS: From 1993-6, SOM was successfully performed on both the pancreatic and bile ducts in 593 patients who had idiopathic pancreatitis or pain suggestive of a pancreatobiliary origin. One to three station pull throughs were done in each duct using the Wilson-Cook aspirating triple lumen catheter perfused at .25 ml/min/lumen. The basal sphincter pressure was determined for each lead and averaged for all pull throughs for that duct. A basal sphincter pressure ≥ 40 mmHg was considered abnormal. Phasic waves were not tallied. RESULTS: ABNORMAL BASAL SPHINCTER PRESSURE ({\%}) Prior Sphincter Therapy Pancreas Alone Biliary Alone Both Total Yes (n=232) 87 (37{\%}) 1 (.5{\%}) 20 (9{\%}) 108 (47{\%}) No (n=360) 68 (19{\%}) 41 (11{\%}) 113(31{\%}) 222 (62{\%}) SUMMARY: 1) Basal sphincter pressure abnormalities are present at SOM in more than one-half of thoroughly studied patients in our ERCP unit. 2) Concordance between biliary and pancreatic (both normal or abnormal) basal sphincter pressure for previously untreated patients was 70{\%}. 3) After biliary sphincterotomy, symptomatic patients have a high frequency of pancreatic basal sphincter abnormalities. CONCLUSION: Both pancreatic and biliary portions of the sphincter of Oddi must be evaluated to fully define sphincter dysfunction.",
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