Biliary sphincter of Oddi dysfunction: response rates after ERCP and sphincterotomy in a 5-year ERCP series and proposal for new practical guidelines.

2.50
Hdl Handle:
http://hdl.handle.net/10147/138380
Title:
Biliary sphincter of Oddi dysfunction: response rates after ERCP and sphincterotomy in a 5-year ERCP series and proposal for new practical guidelines.
Authors:
Heetun, Zaid S; Zeb, Faisal; Cullen, Garrett; Courtney, Garry; Aftab, Abdur Rahman
Affiliation:
Department of Gastroenterology, St Luke's Hospital, Kilkenny, Ireland. heetunz@gmail.com
Citation:
Biliary sphincter of Oddi dysfunction: response rates after ERCP and sphincterotomy in a 5-year ERCP series and proposal for new practical guidelines. 2011, 23 (4):327-33 Eur J Gastroenterol Hepatol
Journal:
European journal of gastroenterology & hepatology
Issue Date:
Apr-2011
URI:
http://hdl.handle.net/10147/138380
DOI:
10.1097/MEG.0b013e3283433aa1
PubMed ID:
21383625
Abstract:
The diagnosis and management of sphincter of Oddi dysfunction (SOD) is challenging.; Retrospective review of endoscopic retrograde cholangiopancreatographies (ERCPs) performed for biliary SOD between 2003 and 2007 and proposal for new management guidelines.; Patients were identified from the ERCP database. All patients had a history of typical biliary pain and were classified into three groups - group 1: patients with dilated common bile duct and abnormal laboratory investigations at time of pain; group 2: either of the above; group 3: none of the above. All patients underwent ERCP and endoscopic sphincterotomy (ES). Sphincter of Oddi manometry was not carried out. Patients were contacted 18 months after procedure with regard to relief of pain and complications.; Seventy-two patients were included - 16.7% male and 83.3% female with an average age of 54.2 years. Ampullary stenosis was found in 76.2% of patients in group 1 and 70% in group 2 compared with 30% in group 3. In group 1, 90.5% of patients reported complete relief of pain compared with 75 and 50% in groups 2 and 3, respectively. Among them 55.6% of patients had previous cholecystectomy. Overall 85% of cholecystectomized patients and 81.3% of patients with an intact gallbladder had complete response to ES. There were no complications in all three groups.; Our findings are similar to other studies documenting response rates to ES in manometry proven SOD. Our simpler guidelines are more applicable to clinical practice. Group 3 remains the most challenging group. Risk and benefits of ERCP and ES should be discussed with patients in centres where sphincter of Oddi manometry is unavailable, noting that 50% of patients respond favourably to ES.
Item Type:
Article
Language:
en
MeSH:
Adult; Aged; Cholangiopancreatography, Endoscopic Retrograde; Clinical Protocols; Female; Humans; Male; Middle Aged; Retrospective Studies; Sphincter of Oddi Dysfunction; Sphincterotomy, Endoscopic; Treatment Outcome; Young Adult
ISSN:
1473-5687

Full metadata record

DC FieldValue Language
dc.contributor.authorHeetun, Zaid Sen
dc.contributor.authorZeb, Faisalen
dc.contributor.authorCullen, Garretten
dc.contributor.authorCourtney, Garryen
dc.contributor.authorAftab, Abdur Rahmanen
dc.date.accessioned2011-07-28T15:28:44Z-
dc.date.available2011-07-28T15:28:44Z-
dc.date.issued2011-04-
dc.identifier.citationBiliary sphincter of Oddi dysfunction: response rates after ERCP and sphincterotomy in a 5-year ERCP series and proposal for new practical guidelines. 2011, 23 (4):327-33 Eur J Gastroenterol Hepatolen
dc.identifier.issn1473-5687-
dc.identifier.pmid21383625-
dc.identifier.doi10.1097/MEG.0b013e3283433aa1-
dc.identifier.urihttp://hdl.handle.net/10147/138380-
dc.description.abstractThe diagnosis and management of sphincter of Oddi dysfunction (SOD) is challenging.-
dc.description.abstractRetrospective review of endoscopic retrograde cholangiopancreatographies (ERCPs) performed for biliary SOD between 2003 and 2007 and proposal for new management guidelines.-
dc.description.abstractPatients were identified from the ERCP database. All patients had a history of typical biliary pain and were classified into three groups - group 1: patients with dilated common bile duct and abnormal laboratory investigations at time of pain; group 2: either of the above; group 3: none of the above. All patients underwent ERCP and endoscopic sphincterotomy (ES). Sphincter of Oddi manometry was not carried out. Patients were contacted 18 months after procedure with regard to relief of pain and complications.-
dc.description.abstractSeventy-two patients were included - 16.7% male and 83.3% female with an average age of 54.2 years. Ampullary stenosis was found in 76.2% of patients in group 1 and 70% in group 2 compared with 30% in group 3. In group 1, 90.5% of patients reported complete relief of pain compared with 75 and 50% in groups 2 and 3, respectively. Among them 55.6% of patients had previous cholecystectomy. Overall 85% of cholecystectomized patients and 81.3% of patients with an intact gallbladder had complete response to ES. There were no complications in all three groups.-
dc.description.abstractOur findings are similar to other studies documenting response rates to ES in manometry proven SOD. Our simpler guidelines are more applicable to clinical practice. Group 3 remains the most challenging group. Risk and benefits of ERCP and ES should be discussed with patients in centres where sphincter of Oddi manometry is unavailable, noting that 50% of patients respond favourably to ES.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshCholangiopancreatography, Endoscopic Retrograde-
dc.subject.meshClinical Protocols-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshRetrospective Studies-
dc.subject.meshSphincter of Oddi Dysfunction-
dc.subject.meshSphincterotomy, Endoscopic-
dc.subject.meshTreatment Outcome-
dc.subject.meshYoung Adult-
dc.titleBiliary sphincter of Oddi dysfunction: response rates after ERCP and sphincterotomy in a 5-year ERCP series and proposal for new practical guidelines.en
dc.typeArticleen
dc.contributor.departmentDepartment of Gastroenterology, St Luke's Hospital, Kilkenny, Ireland. heetunz@gmail.comen
dc.identifier.journalEuropean journal of gastroenterology & hepatologyen
dc.description.provinceLeinster-

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