Background: Sphincter of Oddi dysfunction (SOD) of the biliary sphincter has been reported to be more frequent in pancreas divisum. We reviewed a large series of pancreas divisum patients to determine the frequency of abnormal SO manometry in our referral population. Methods: From 1/94-11/97, 603 ERCPs were performed on 367 patients with pancreas divisum. Biliary sphincter of Oddi manometry (SOM) was performed in 139 patients in the conventional retrograde fashion using a triple-lumen aspirating catheter. One to three station pull-throughs were performed and mean basal biliary sphincter pressure determined. Indications for SOM included Type II/III SOD (Geenen-Hogan classification) in 95 patients and idiopathic pancreatitis (IRP) in 44 patients. SOD was denned as a basal sphincter pressure s 40 mm Hg. Results: SOD IN PANCREAS DIVISUM PATIENTS SOM Idiopathic Pancreatitis (n) Type II/III SOD (n) Normal 20 50 SOD 24 45 Overall, abnormal basal biliary sphincter pressure was found in 69/139 patients (50%) with pancreas divisum. Summary: In our series of pancreas divisum patients, the incidence of biliary SOD is approximately 50%. Conclusion: Therapeutic decisions should be guided by the patient's clinical presentation (idiopathic pancreatitis, LFTs, bile duct diameter). SOD may be a cause for lack of response to minor papilla therapy. However, further studies with long-term follow-up data are required to determine the optimal management strategy in patients with SOD and pancreas divisum.
|Original language||English (US)|
|State||Published - Dec 1 1998|
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging