Endoscopic sphincterotomy for stenosis of the sphincter of Oddi

Surgical Endoscopy
C SugawaK Ukawa

Abstract

Sphincter of Oddi dysfunction (SOD) is one of the causes of postcholecytectomy syndrome and biliary pain. Endoscopic sphincterotomy (EST) is recommended in some cases for patients refractory to conservative treatment. By the Milwaukee classification, patients with biliary pain can be divided into three groups. Group I patients show all the objective signs suggestive of a disturbed bile outflow-i.e., elevated liver function tests, dilated common bile duct (CBD), and delayed contrast drainage during endoscopic retrograde cholangio pancreatography (ERCP). Group II patients have biliary-type pain along with one or two of the criteria from group I. Group III patients have only biliary pain, with no other abnormalities. This study confirms the effectiveness of EST for the relief of symptoms in group I patients (papillary stenosis). Between 1989 and 1999, we treated eight patients clinically diagnosed as having group I papillary stenosis by EST. Their ages ranged from 52 to 73 years. In addition to biliary pain, all patients were found to have dilated CBD, elevated enzyme levels, and delayed contrast drainage at ERCP. None of the patients had CBD stones or other causes of obstruction. Sphincter of Oddi manometry was not performed. EST...Continue Reading

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Citations

Jun 13, 2012·Langenbeck's Archives of Surgery·Thomas C HallGiuseppe Garcea
Apr 17, 2004·Journal of Clinical Gastroenterology·Giuseppe PiccinniGiovanni Martino Bonomo
Nov 23, 2007·Journal of Gastroenterology and Hepatology·Sudipta MisraCharles C Chen
Jan 22, 2011·World Journal of Gastroenterology : WJG·Jia-Qing GongYong Pang
Jul 29, 2009·Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association·Zakaria M Hazem
Nov 17, 2012·Clinical Imaging·Nava P GreenfieldFergus V Coakley
Aug 17, 2006·Pediatrics International : Official Journal of the Japan Pediatric Society·Elif YilmazFügen Cokuğraşçullu
Apr 10, 2009·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Katherine A MorganDavid B Adams
Apr 26, 2005·World Journal of Gastroenterology : WJG·Zhi-Hua LiJia-Hong Dong
Jun 29, 2006·World Journal of Gastroenterology : WJG·Lana Bistritz, Vincent G Bain
Aug 27, 2019·Therapeutic Advances in Gastrointestinal Endoscopy·Hiroyuki MiyataniSatohiro Matsumoto
Feb 23, 2021·Frontline Gastroenterology·Muhammad IshtiaqSimon M Everett

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