Functional Gallbladder and Sphincter of Oddi Disorders

Jose Behar, Enrico Corazziari, Moises Guelrud, Walter Hogan, Stuart Sherman, James Toouli

Research output: Contribution to journalArticle

182 Citations (Scopus)

Abstract

The functional disorder of the gallbladder (GB) is a motility disorder caused initially either by metabolic abnormalities or by a primary motility alteration. The functional disorders of the sphincter of Oddi (SO) encompass motor abnormalities of either the biliary or the pancreatic SO. Dysfunction of the GB and/or biliary SO produce similar patterns of pain. The pain caused by a dysfunction of the pancreatic SO can be similar to that of acute pancreatitis. The symptom-based diagnostic criteria of motility dysfunction of the GB and biliary SO are episodes of moderate to severe steady pain located in the epigastrium and right upper abdominal quadrant that last at least 30 minutes. GB motility disorder is suspected after gallstones and other structural abnormalities have been excluded. This diagnosis should then be confirmed by a decreased GB ejection fraction induced by cholecystokinin at cholescintigraphy and after disappearance of the recurrent biliary pain after cholecystectomy. Symptoms of biliary SO dysfunction may be accompanied by features of transient biliary obstruction, and those of pancreatic SO dysfunction are associated with elevation of pancreatic enzymes and even pancreatitis. Biliary-type SO dysfunction is more frequently recognized in postcholecystectomy patients. SO manometry is valuable to select patients with sphincter dysfunction; however, because of the high incidence of complications, these patients should be referred to an expert unit for such assessment. Thus invasive tests should be performed only in the presence of compelling clinical evidence and after noninvasive testing has yielded negative findings. The committee recommends that division of the biliary or pancreatic sphincters only be considered when the patient has severe symptoms, meets the required criteria, and other diagnoses are excluded.

Original languageEnglish
Pages (from-to)1498-1509
Number of pages12
JournalGastroenterology
Volume130
Issue number5
DOIs
StatePublished - May 2006

Fingerprint

Sphincter of Oddi
Sphincter of Oddi Dysfunction
Gallbladder
Pain
Pancreatitis
Cholecystokinin
Manometry
Cholecystectomy
Gallstones
Incidence
Enzymes

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Behar, J., Corazziari, E., Guelrud, M., Hogan, W., Sherman, S., & Toouli, J. (2006). Functional Gallbladder and Sphincter of Oddi Disorders. Gastroenterology, 130(5), 1498-1509. https://doi.org/10.1053/j.gastro.2005.11.063

Functional Gallbladder and Sphincter of Oddi Disorders. / Behar, Jose; Corazziari, Enrico; Guelrud, Moises; Hogan, Walter; Sherman, Stuart; Toouli, James.

In: Gastroenterology, Vol. 130, No. 5, 05.2006, p. 1498-1509.

Research output: Contribution to journalArticle

Behar, J, Corazziari, E, Guelrud, M, Hogan, W, Sherman, S & Toouli, J 2006, 'Functional Gallbladder and Sphincter of Oddi Disorders', Gastroenterology, vol. 130, no. 5, pp. 1498-1509. https://doi.org/10.1053/j.gastro.2005.11.063
Behar J, Corazziari E, Guelrud M, Hogan W, Sherman S, Toouli J. Functional Gallbladder and Sphincter of Oddi Disorders. Gastroenterology. 2006 May;130(5):1498-1509. https://doi.org/10.1053/j.gastro.2005.11.063
Behar, Jose ; Corazziari, Enrico ; Guelrud, Moises ; Hogan, Walter ; Sherman, Stuart ; Toouli, James. / Functional Gallbladder and Sphincter of Oddi Disorders. In: Gastroenterology. 2006 ; Vol. 130, No. 5. pp. 1498-1509.
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