Incidence of sphincter of Oddi dysfunction in patients with pancreas divisum

Evan Fogel, C. P. Choudari, L. G. Bucksot, J. Flueckiger, Stuart Sherman, Glen Lehman

Research output: Contribution to journalArticle

Abstract

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 languageEnglish
JournalGastrointestinal Endoscopy
Volume47
Issue number4
StatePublished - 1998

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Sphincter of Oddi Dysfunction
Pancreas
Incidence
Manometry
Sphincter of Oddi
Pancreatitis
Pressure
Endoscopic Retrograde Cholangiopancreatography
Bile Ducts
Referral and Consultation
Catheters

ASJC Scopus subject areas

  • Gastroenterology

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Incidence of sphincter of Oddi dysfunction in patients with pancreas divisum. / Fogel, Evan; Choudari, C. P.; Bucksot, L. G.; Flueckiger, J.; Sherman, Stuart; Lehman, Glen.

In: Gastrointestinal Endoscopy, Vol. 47, No. 4, 1998.

Research output: Contribution to journalArticle

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abstract = "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.",
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T1 - Incidence of sphincter of Oddi dysfunction in patients with pancreas divisum

AU - Fogel, Evan

AU - Choudari, C. P.

AU - Bucksot, L. G.

AU - Flueckiger, J.

AU - Sherman, Stuart

AU - Lehman, Glen

PY - 1998

Y1 - 1998

N2 - 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.

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