Sphincter of Oddi dysfunction: Diagnosis and treatment

Research output: Contribution to journalReview article

63 Scopus citations

Abstract

In summary, our knowledge of sphincter of Oddi dysfunction and manometric techniques to assist in this diagnosis are evolving. Successful endoscopic SOM requires good general ERCP skills and careful attention to the main details listed above. If SOD is suspected in a Type III or mild to moderate pain level Type II patient, medical therapy should generally be tried. If medical therapy fails or is bypassed, ERCP and manometric evaluation are recommended. The role of lessinvasive studies remains uncertain due to undefined sensitivity and specificity. Sphincter ablation is generally warranted in symptomatic Type I patients and Type II and III patients with abnormal manometry. The symptom relief rate varies from 55 to 95%, depending on the patient presentation and selection. Initial non-responders require thorough pancreatic sphincter and pancreatic parenchymal evaluation. SOD patients have relatively high complication rates after invasive studies or therapy. Thorough review of the risk: benefit ratio with individual patients is mandatory.

Original languageEnglish (US)
Pages (from-to)382-400
Number of pages19
JournalJournal of the Pancreas
Volume2
Issue number6
StatePublished - Nov 1 2001

Keywords

  • Cholangiopancreatography, endoscopy retrograde
  • Manometry
  • Oddi's sphincter
  • Pancreatitis, acute necrotizing
  • Sphincterotomy, endoscopic

ASJC Scopus subject areas

  • Endocrinology
  • Gastroenterology

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