Repeat pancreatic sphincter manometry after biliary sphincterotomy in patients with sphincter of oddi dysfunction

Tamasky, PR; Cunningham, J; Knapple, Whitfield L.; Yeoh, Kheng-Wei; McPherson, Craig A.; Brooker, C; Pb, Cotton; Hawes, R.

doi:10.1016/s0016-5107(97)80505-6

Cited by 6 publications

(6 citation statements)

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“…After elimination of other etiologies for recurrent pancreatitis, SOM may be considered to evaluate for SOD. Biliary sphincterotomy, with its ability also to lower pancreatic basal pressure [ 42 ], has prevented further episodes of pancreatitis in 50% of adult patients [ 26 ]. Pancreatic sphincterotomy and dual sphincterotomy both have been shown to be superior to biliary sphincterotomy alone for recurrent pancreatitis in adults [ 43 ].…”

Section: Pancreatic Sod: Sphincter Ablationmentioning

confidence: 99%

Biliary dyskinesia in the pediatric patient

Halata

Berezin²

2008

Curr Gastroenterol Rep

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The term biliary dyskinesia commonly describes a motility disorder of the biliary tract that is divided into two main categories: gallbladder dyskinesia (GBD) and sphincter of Oddi dysfunction (SOD). SOD is further subdivided into biliary SOD and pancreatic SOD. GBD causes typical biliary colic without gallstones, whereas SOD typically presents with recurrent pancreatitis or chronic abdominal pain, usually after cholecystectomy. GBD and SOD are uncommon in children. Based on adult experience, this review discusses the diagnosis and treatment of GBD and SOD in the pediatric population.

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Section: Pancreatic Sod: Sphincter Ablationmentioning

confidence: 99%

Biliary dyskinesia in the pediatric patient

Halata

Berezin²

2008

Curr Gastroenterol Rep

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“…Patients with SOD have been found to have PSH with or without simultaneous elevations of basal biliary sphincter pressures [27 -30]. Residual PSH has also been found to exist in some patients immediately after biliary sphincterotomy [31]. Patients with PSH have also been shown to have an increased risk of post-ERCP pancreatitis [11].…”

Section: Discussionmentioning

confidence: 99%

Botulinum Toxin Injection after Biliary Sphincterotomy

et al. 2004

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Biliary sphincterotomy in patients with sphincter of Oddi dysfunction without pancreatic protection is risky and should no longer be carried out. This study demonstrates that botulinum toxin injection into the residual pancreatic sphincter after biliary sphincterotomy is technically feasible and safe, showing a trend toward a reduced post-ERCP pancreatitis rate in patients with sphincter of Oddi dysfunction. Further studies will need to confirm the validity of these experimental results before this technique can be used routinely.

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“…These older series usually failed to define which sphincter was studied and gave limited data on "improved" status after biliary sphincterotomy. However, BES has been shown by Tarnasky et al [23] to lower pancreatic basal sphincter pressure to within the normal range in 30% of patients immediately after BES and in 20% remotely following BES. This finding can be explained by 1) the common channel sphincter (which would be recorded as a component of both biliary and pancreatic sphincters during station pull-through); 2) ablation of the common channel sphincter during BES, thereby shortening the length of the residual pancreatic sphincter; and 3) presence of muscle fibers in a figure-eight and overlapping configuration, which is severed during BES, hence lowering the pancreatic basal sphincter pressure (Fig.…”

Section: Biliary Sphincter Ablation Alonementioning

confidence: 96%

Sphincter of oddi (pancreatic) hypertension and recurrent pancreatitis

Devereaux

Sherman

Lehman

2002

Curr Gastroenterol Rep

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Major papilla pancreatic sphincter dysfunction, a variant of sphincter of Oddi dysfunction, causes pancreatitis and pancreatic-type pain. The gold standard for diagnosis is sphincter of Oddi manometry, most commonly performed at endoscopic retrograde cholangiopancreatography (ERCP). Noninvasive testing, such as secretin-stimulated transabdominal or endoscopic ultrasound assessment of pancreatic duct diameter, is less reliable and has relatively low sensitivity. Two thirds of patients with biliary sphincter of Oddi dysfunction have elevated pancreatic basal sphincter pressure. To maximize the diagnostic yield of sphincter of Oddi dysfunction, both the biliary and pancreatic sphincter pressures should be measured. Patients with sphincter of Oddi dysfunction may respond to biliary sphincterotomy alone, but evaluation of their pancreatic sphincter is warranted if symptoms persist after biliary therapy alone. Whether both biliary and pancreatic sphincters should be treated at the first ERCP session is controversial. Biliary and pancreatic endoscopic sphincterotomies are associated with two- to fourfold increased incidence of pancreatitis following the procedure in patients with pancreatic sphincter hypertension. Prophylactic pancreatic duct stenting reduces the frequency and severity of complications by greater than 50%.

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Repeat pancreatic sphincter manometry after biliary sphincterotomy in patients with sphincter of oddi dysfunction

Cited by 6 publications

References 0 publications

Biliary dyskinesia in the pediatric patient

Biliary dyskinesia in the pediatric patient

Botulinum Toxin Injection after Biliary Sphincterotomy

Sphincter of oddi (pancreatic) hypertension and recurrent pancreatitis

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