Frequency of biliary crystals in patients with suspected sphincter of Oddi dysfunction

Rashdan, Abdullah; Fogel, Evan L.; McHenry, Lee; Lehman, Glen A.; Sherman, Stuart

doi:10.1016/s0016-5107(03)02311-3

Cited by 28 publications

(14 citation statements)

References 11 publications

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“…CBD stones, sludge or cholesterol crystals. This is in contrast to others who found microlithiasis to be rare in patients with suspected type II SOD [32]. Given the substantially heightened complication rates from ES in this category of patients [17,25], and considering that only a subgroup of the types II and III patients have SOD, empirical ES in these is doubtful.…”

contrasting

confidence: 58%

Sphincter of Oddi – still mysterious, still complicated

Rolny¹

2005

Scandinavian Journal of Gastroenterology

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contrasting

confidence: 58%

Sphincter of Oddi – still mysterious, still complicated

Rolny¹

2005

Scandinavian Journal of Gastroenterology

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“…SOD is a syndrome that is characterized by chronic biliary pain or recurrent pancreatitis due to functional obstruction of the pancreaticobiliary flow at the level of the sphincter of Oddi. 10 The Milwaukee classification system 11 stratifies patients according to their clinical picture based on elevated liver enzymes, a dilated common bile duct and the presence of abdominal pain. Type I SOD patients have pain as well as abnormal liver enzymes and a dilated common bile duct; type II SOD patients have pain and only one objective finding; and type III SOD patients only have biliary pain. 12 This classification system is useful for guiding diagnosis and management of SOD.…”

Section: Skalicky Impact Of Cholecystectomy On the Papilla Of Vatermentioning

confidence: 99%

The Size of the Papilla of Vater and Its Relation to Its Height in Comparison with the Visibility of the Sphincter of Oddi before and after Cholecystectomy

Skalicky

2011

J Int Med Res

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This study investigated the changes in the surface area and height of the papilla of Vater (PV) and the visibility of the sphincter of Oddi complex (SOK) using endoscopic ultrasound (EUS) examinations of 80 patients with symptomatic gallstones before and at 3 and 6 months after cholecystectomy. Following surgery, 50 patients experienced early atypical symptoms characteristic of postcholecystectomy syndrome (PCS) and 30 patients were asymptomatic. The PV measurements were greater in all patients compared with normal reference values and increased significantly from before surgery to 3 months postsurgery. At 6 months postsurgery, both the surface area and height of the PV had significantly decreased to preoperative values but remained higher than normal. The proportion of patients with a visible SOK had increased by 3 months postsurgery but had reduced again by 6 months. There were no significant differences between symptomatic and asymptomatic patients, suggesting that the changes observed in the PV and SOK do not explain the presence of the atypical symptoms of PCS.

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“…Microscopic examination of bile aspirate in patients with B-SOD type II and III has shown a low prevalence (3.5-5%) of biliary microcrystals [21,22]. These studies, however, have excluded the B-SOD I patients and the prevalence of biliary microcrystals in these patients is not known.…”

Section: Discussionmentioning

confidence: 99%

Biliary Sphincter of Oddi Dysfunction Type I Versus Occult Biliary Microlithiasis in Post-cholecystectomy Patients: Are They Both Part of the Same Clinical Entity?

Elmi

Silverman

2009

Dig Dis Sci

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We speculate that biliary sphincter of Oddi dysfunction type I and symptomatic migrating biliary microlithiasis may be part of the same disease process. A retrospective analysis of prospectively collected data was carried out using procedure and diagnosis codes during the period of 1997-2006. Seventeen patients (age 51 +/- 17; 94% women) with prior cholecystectomy, right upper quadrant/epigastric abdominal pain, elevated liver enzymes, dilated biliary ducts seen on ultrasound/CT scan were identified. The patients underwent ERCP with biliary endoscopic sphincterotomy. Nine (53%) had biliary microlithiasis and eight (47%) had biliary sphincter of Oddi dysfunction type I. They were followed for 2-108 weeks (median 9 weeks). 6/8 (75%) in biliary sphincter of Oddi dysfunction type I and 6/9 (67%) in biliary microlithiasis group had resolution of abdominal pain (P = 1.00). We conclude that the clinical improvement with biliary sphincterotomy for biliary sphincter of Oddi dysfunction type I versus occult biliary microlithiasis was not significantly different.

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Frequency of biliary crystals in patients with suspected sphincter of Oddi dysfunction

Cited by 28 publications

References 11 publications

Sphincter of Oddi – still mysterious, still complicated

Sphincter of Oddi – still mysterious, still complicated

The Size of the Papilla of Vater and Its Relation to Its Height in Comparison with the Visibility of the Sphincter of Oddi before and after Cholecystectomy

Biliary Sphincter of Oddi Dysfunction Type I Versus Occult Biliary Microlithiasis in Post-cholecystectomy Patients: Are They Both Part of the Same Clinical Entity?

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