Hepatoduodenal bile transit in cholecystectomized subjects

Corazziari, Enrico; Cicala, Michele; Habib, F. I.; Scopinaro, Francesco; Fiocca, Fausto; Pallotta, Nadia; Viscardi, Andrea; Vignoni, Alberto; Torsoli, A

doi:10.1007/bf02088136

Cited by 58 publications

(4 citation statements)

References 18 publications

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“…Although 1 study showed promise for scintigraphic drainage tests in predicting biliary SOD (with a high proportion of patients with dilated biliary trees), 15 this has not been reproduced by others: Darweesch et al, 16 67% sensitivity; Corazziari et al, 17 50% specificity; and Craig et al, 18 25% to 38% sensitivity. It is not surprising that patients with normal-size bile ducts will likely have different drainage determinants and that biliary scintigraphy is not likely to predict pancreatic sphincter abnormalities well.…”

Section: Discussionmentioning

confidence: 95%

Can patient and pain characteristics predict manometric sphincter of Oddi dysfunction in patients with clinically suspected sphincter of Oddi dysfunction?

Romagnuolo

Cotton

Durkalski

et al. 2014

Gastrointestinal Endoscopy

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Background Biliopancreatic-type postcholecystectomy pain, without significant abnormalities on imaging and laboratory test results, has been categorized as “suspected” sphincter of Oddi dysfunction (SOD) type III. Clinical predictors of “manometric” SOD are important to avoid unnecessary ERCP, but are unknown. Objective To assess which clinical factors are associated with abnormal sphincter of Oddi manometry (SOM). Design Prospective, cross-sectional. Setting Tertiary. Patients A total of 214 patients with suspected SOD type III underwent ERCP and pancreatic SOM (pSOM; 85% dual SOM), at 7 U.S. centers (from August 2008 to March 2012) as part of a randomized trial. Interventions Pain and gallbladder descriptors, psychosocial/functional disorder questionnaires. Main Outcome Measurements Abnormal SOM findings. Univariate and multivariate analyses assessed associations between clinical characteristics and outcome. Results The cohort was 92% female with a mean age of 38 years. Baseline pancreatic enzymes were increased in 5%; 9% had minor liver enzyme abnormalities. Pain was in the right upper quadrant (RUQ) in 90% (48% also epigastric); 51% reported daily abdominal discomfort. Fifty-six took narcotics an average of 33 days (of the past 90 days). Less than 10% experienced depression or anxiety. Functional disorders were common. At ERCP, 64% had abnormal pSOM findings (34% both sphincters, 21% biliary normal), 36% had normal pSOM findings, and 75% had at least abnormal 1 sphincter. Demographic factors, gallbladder pathology, increased pancreatobiliary enzymes, functional disorders, and pain patterns did not predict abnormal SOM findings. Anxiety, depression, and poorer coping were more common in patients with normal SOM findings (not significant on multivariate analysis). Limitations Generalizability. Conclusions Patient and pain factors and psychological comorbidity do not predict SOM results at ERCP in suspected type III SOD. (Clinical Trial registration number: NCT00688662.) (Gastrointest Endosc 2014;79:765-72.)

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Section: Discussionmentioning

confidence: 95%

Can patient and pain characteristics predict manometric sphincter of Oddi dysfunction in patients with clinically suspected sphincter of Oddi dysfunction?

Romagnuolo

Cotton

Durkalski

et al. 2014

Gastrointestinal Endoscopy

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“…The mean biliointestinal (bilioduodenal) transit time in patients with PCS in the present study was 12.7 ± 13.3 minutes. Corazziari et al 9 reported a mean biliointestinal (bilioduodenal) transit time of 12.5 ± 2.2 minutes in patients with post cholecystectomy pain and a mean biliointestinal (bilioduodenal) transit time of 6.7 ± 2.6 minutes in asymptomatic controls, thus showing an obvious delay in the PCS patients. The bile duct to the jejunum transit time (mean = 30.1 minutes) was also markedly increased compared with the bile duct to the duodenum transit time (mean = 12.7 minutes) in the patients with PCS.…”

Section: Discussionmentioning

confidence: 99%

Role of 99mTc-Mebrofenin Hepatobiliary Scintigraphy in the Diagnosis of Post Cholecystectomy Syndrome

et al. 2022

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Background Huge variation in the prevalence of post cholecystectomy syndrome (PCS) is because PCS can include a wide variety of disorders that can be both related and unrelated to cholecystectomy. Hepatobiliary scintigraphy (HBS) is a noninvasive nuclear medicine scan that can evaluate a delay in the transit of bile from the hepatic hilum to the duodenum using a radiotracer 99mTc-Mebrofenin that can be associated with a functional ampullary obstruction. The aim of this study was to assess the role of 99mTc-Mebrofenin HBS in the detection of the cause of PCS among the patients undergoing cholecystectomy. Methods Twenty-one patients who presented with PCS from September 2018 to February 2020 were included in the study. These patients were characterized based on history, examination, liver function test, and abdominal ultrasound. Sphincter of Oddi dysfunction (SOD) was diagnosed using the Rome 3 criteria and the Milwaukee classification. Magnetic resonance cholangiopancreatography (MRCP) and upper gastrointestinal endoscopy and biopsy were done when indicated, to establish the diagnosis. These patients were further subjected to 99mTc-Mebrofenin HBS, and the findings were analyzed. Results The most common symptom in PCS was biliary pain occurring in 85.7% of the patients. The average time of presentation since surgery was 1.9 years. The most common cause of PCS was SOD, occurring in 52.3% of the patients, followed by benign biliary stricture occurring in 23.8% of the patients. The mean bile duct (common bile duct) visualization time in patients with PCS was 25.2 minutes, the mean duodenal visualization time was 38.2 minutes, and the mean jejunal visualization time was 60.5 minutes. The mean bile duct to duodenum transit time was 12.7 minutes, while the mean bile duct to jejunum transit time was 30.1 minutes. HBS showed consistent findings with the final diagnosis made by other diagnostic modalities (clinical criteria/MRCP/intraoperative findings) in 80.9% of the patients. Conclusion 99mTc-Mebrofenin HBS has a significant role in the evaluation of PCS.

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“…Los pacientes con disfunción del esfínter de Oddi tipo II y III son de diagnóstico y manejo controvertidos. En nuestra opinión, todo paciente con sospecha de disfunción del esfínter de Oddi tipo II y III debe ser llevado a gammagrafía hepatobiliar pre-CPRE debido a que la especificidad del estudio de medicina nuclear es al menos del 90 % (14,(31)(32)(33)(34). Además, en la evaluación del dolor tipo biliar pos-…”

Section: Fuente De Financiaciónunclassified

Disfunción del esfínter de Oddi: un reporte de caso

Peñaloza-Ramírez

Coral-Argoty

Castro-Rodríguez

et al. 2021

Rev colomb Gastroenterol

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La disfunción del esfínter de Oddi es un síndrome clínico causado por una enfermedad funcional (discinesia) o estructural (estenosis). La prevalencia estimada de disfunción del esfínter de Oddi en la población en general es del 1 %; aumentando a 20 % para pacientes con dolor persistente posterior a colecistectomía y a 70 % en pacientes con pancreatitis aguda recurrente idiopática. Se caracteriza clínicamente por la presencia de dolor abdominal, similar al cólico biliar o dolor tipo pancreático en ausencia de patología biliar orgánica; así como en pacientes con pancreatitis recurrente idiopática asociada con elevación de enzimas pancreáticas o hepáticas, y dilatación del conducto biliar o pancreático. El tratamiento para la disfunción del esfínter de Oddi tipo I se basa en la realización de esfinterotomía endoscópica, pero existe controversia en el manejo de la disfunción del esfínter de Oddi tipo II y III. En este artículo se presenta el caso clínico de una paciente de 67 años con antecedente de colecistectomía por laparotomía. Después del procedimiento quirúrgico refirió un dolor abdominal de predominio en el hipocondrio derecho tipo cólico asociado con emesis de características biliares. En el reporte de colangiorresonancia se encontró una ligera dilatación de la vía biliar intrahepática y gammagrafía con ácido iminodiacético hepatobiliar (HIDA) diagnóstica de disfunción del esfínter de Oddi. Se realizó una esfinterotomía endoscópica. En el seguimiento, dos años después, la paciente se encontraba asintomática con la disfunción del esfínter de Oddi resuelta.

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Hepatoduodenal bile transit in cholecystectomized subjects

Cited by 58 publications

References 18 publications

Can patient and pain characteristics predict manometric sphincter of Oddi dysfunction in patients with clinically suspected sphincter of Oddi dysfunction?

Can patient and pain characteristics predict manometric sphincter of Oddi dysfunction in patients with clinically suspected sphincter of Oddi dysfunction?

Role of 99mTc-Mebrofenin Hepatobiliary Scintigraphy in the Diagnosis of Post Cholecystectomy Syndrome

Disfunción del esfínter de Oddi: un reporte de caso

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