Sphincterotomy by needle-knife over pancreatic steni technique lowers the post-procedure pancreatitis frequency and severity in sphincter of Oddi dysfunction (SOD) patients

Pancreatic Sphincter Precutting to Gain Selective Access to the Common Bile Duct: A Series of 172 Patients

“…The frequency of pancreatitis after PSP in our patients with suspected SOD Table 5 The incidence and severity of pancreatitis after precut procedures in patients with sphincter of Oddi dysfunction (SOD) in our study and in previous studies Kasmin et al [11] O'Connor et al [12] Rollhauser et al [ Original Article was similar (14.3 %, 1/7). However, the severity of pancreatitis after PSP in our patients was milder than that reported by Sherman et al [14,15]. We have previously proposed that inadequate opening of the pancreatic duct is responsible for the high frequency of moderate-to-severe pancreatitis after needle-knife sphincterotomy [7].…”

“…Our results therefore suggest that in patients with suspected SOD there is some unknown factor (or factors) predisposing them to an increased risk of pancreatitis after ES. Sherman et al [15] reported that the frequency of pancreatitis in patients with suspected SOD after pancreatic sphincterotomy (needle-knife over pancreatic stent technique) was 11.8 % (11/93). The frequency of pancreatitis after PSP in our patients with suspected SOD Table 5 The incidence and severity of pancreatitis after precut procedures in patients with sphincter of Oddi dysfunction (SOD) in our study and in previous studies Kasmin et al [11] O'Connor et al [12] Rollhauser et al [ Original Article was similar (14.3 %, 1/7).…”

Endoscopic injection of botulinum toxin in patients with recurrent acute pancreatitis due to pancreatic sphincter of Oddi dysfunction

“…The performance of endoscopic pancreatic sphincterotomy based solely on the clinical suspicion of pancreatic duct obstruction (without manometry) also does not seem advisable since pancreatic sphincterotomy in this patient population is associated with a substantial risk for pancreatitis (21% in this series) and the clinical benefit is uncertain (the frequency of sphincter of Oddi in patients with recurrent pancreatitis is about 50%, and if sphincter of Oddi is documented the response to sphincter ablation is about 80%) 8 , . 10 , 11 , 23 –25 …”

“…5 , 8 , 10 , 11 , 21 , 22 Post‐interventional pancreatitis, however, was reported in up to 22% of the cases after endoscopic pancreatic sphincterotomy in this situation 8 , . 10 , 11 , 23 –25 …”