Prospective comparison of secretin-stimulated MRCP with manometry in the diagnosis of sphincter of Oddi dysfunction types II and III

Baillie, John; Kimberly, James

doi:10.1136/gut.2006.111278

Cited by 11 publications

(11 citation statements)

References 15 publications

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“…The authors concluded that the test was useful in selecting patients with Type II, but not Type III, disease who would be suitable for sphincterotomy. The study has been criticised, as the 95 % confidence intervals for the positive predictor value were 54-97 % making interpretation of the test 'little better than a coin toss' [21].…”

Section: Diagnostic Methodsmentioning

confidence: 99%

The diagnosis and management of Sphincter of Oddi dysfunction: a systematic review

Hall

Dennison

Garcea

2012

Langenbecks Arch Surg

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Non-invasive investigations currently lack sufficient sensitivities and specificities for routine use in diagnosing SOD. Type I SOD should be treated with ES without manometry. Manometry may be useful for Type II SOD. However, whilst data is lacking a therapeutic trial of Botox(TM) or trial stenting may bean alternative. Careful and thorough patient counselling is essential. Type III SOD is associated with high complications from manometry and poor outcomes from ES. Alternative diagnoses should be thoroughly sought and its management should be medical.

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Section: Diagnostic Methodsmentioning

confidence: 99%

The diagnosis and management of Sphincter of Oddi dysfunction: a systematic review

Hall

Dennison

Garcea

2012

Langenbecks Arch Surg

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“…Since the yield is probably <20%, diagnostic ERCP is no longer recommended in the absence of SOM [38,49,50]. Secretin-enhanced MRCP and EUS and other noninvasive functional tests do not consistently correlate with the results of SOM; therefore, their role in the diagnostic algorithm for patients with idiopathic RAP requires further investigation [51][52][53][54][55]. That said, the implications of diagnosing an RAP patient with sphincter of Oddi dysfunction remain uncertain.…”

Section: Diagnostic Yield Of Ercp In Rapmentioning

confidence: 99%

ERCP in acute and recurrent acute pancreatitis

Coté

2014

Ercp

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“…When the Indiana University ERCP group recently compared ss-MRCP and ERCP, they found that in patients with suspected SOD, ss-ERCP failed to predict the results of SO manometry [20]. A British study that set out to show ss-MRCP could diagnose biliary SOD fared no better [21]. MRCP as a way to reliably diagnose SOD is not ready for "prime time.…”

Section: Alternatives To Som?mentioning

confidence: 99%

Sphincter of Oddi Dysfunction

Baillie

2010

Curr Gastroenterol Rep

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Sphincter of Oddi dysfunction (SOD) is a poorly-understood disorder, typically presenting as postcholecystectomy, "biliary-type," right-sided abdominal and/or chest wall pain. Most patients referred to specialist clinics for work-up of presumed SOD do not, in fact, have anything wrong with their bile ducts or biliary sphincter mechanisms. A careful history and focused physical examination will often identify the true source of the pain syndrome, ranging from chest wall costochondritis and nerve injury at surgical trochar sites, to gastroparesis and visceral hypersensitivity ("irritable bowel"). The Rome III classification of functional gallbladder and biliary disorders defines SOD as episodic (not daily) pain lasting more than 30 min, which is disruptive of normal activities and not associated with bowel upset. It is not relieved by gastric acid suppression or antispasmodics. Other causes of abdominal pain must be excluded. Standard work-up includes endoscopic retrograde cholangiopancreatography (ERCP) with biliary manometry, which risks post-ERCP pancreatitis, especially in young women with normal bile ducts and liver serology. Noninvasive tests for SOD, such as timed ("gated") cholecystokinin (CCK)-stimulated hepatobiliary iminodiacetic acid (HIDA) scans and secretin-stimulated magnetic resonance cholangiopancreatography, are imperfect and still evolving. Although many doubt the very existence of SOD, a multidisciplinary approach to the management of pre- and postcholecystectomy abdominal pain syndromes is long overdue.

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Prospective comparison of secretin-stimulated MRCP with manometry in the diagnosis of sphincter of Oddi dysfunction types II and III

Cited by 11 publications

References 15 publications

The diagnosis and management of Sphincter of Oddi dysfunction: a systematic review

The diagnosis and management of Sphincter of Oddi dysfunction: a systematic review

ERCP in acute and recurrent acute pancreatitis

Sphincter of Oddi Dysfunction

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