Clinical Analysis of 42 Patients with Sphincter of Oddi Dysfunction Treated by Endoscopic Sphincterotomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HAN Min , SUN Chengyi , HU Yun , LI Haiyang.

Department of Hepatobiliary Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, Guizhou Province, China;

Corresponding author：

Keywords：

Endoscopic sphincterotomy; Sphincter of Oddi dysfunction

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ObjectiveTo investigate the value of endoscopic sphincterotomy (EST) on treating sphincter of Oddi dysfunction (SOD). MethodsForty-two patients with SOD according to Rome Ⅱ diagnostic criteria were retrospectively summarized. Bile duct residual stone, tumor or biliopancreatic duct obstruction diseases were excluded by B ultrasound, CT, and MRCP examination. Total 42 patients underwent EST. ResultsEST was done successfully in 42 cases, success rate was 100%. Postoperative acute pancreatitis occurred in 5 patients (11.90%), which were cured by 3－7 d conservative treatment. There were no complications of severe acute pancreatitis, digestive tract perforation, hemorrhage, and cholangitis. Follow-up 12-45 months (mean 23.8 months), symptoms of abdominal pain in all cases were improved or relieved, the effective rate was 100%. There were 2 cases treated conservatively because of hyperlipemic pancreatitis. ConclusionEST has become the primary treatment procedure for SOD because of definite outcome, less suffering, safety, less complications, and reproducibility, which are concordant with the requirements of minimally invasive surgery.

Citation： HAN Min,SUN Chengyi,HU Yun,LI Haiyang.. Clinical Analysis of 42 Patients with Sphincter of Oddi Dysfunction Treated by Endoscopic Sphincterotomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(10): 1091-1094. doi: Copy

1.	Park SH, Watkins JL, Fogel EL, et al. Longterm outcome of endoscopic dual pancreatobiliary sphincterotomy in patients with manometrydocumented sphincter of Oddi dysfunction and normal pancreatogram [J]. Gastrointest Endosc, 2003, 57(4): 483491.
2.	Sugiyama M, Atomi Y. Followup of more than 10 years after endoscopic sphincterotomy for choledocholithiasis in young patients [J]. Br J Surg, 1998, 85(7): 917921.
3.	Hogan WJ, Geenen JE. Biliary dyskinesia [J]. Endoscopy, 1988, 20 Suppl 1: 179183.
4.	BarMeir S, Halpern Z, Bardan E, et al. Frequency of papillary dysfunction among cholecystectomized patients [J]. Hepatology, 1984, 4(2): 328330.
5.	Hawes RH, Tarnasky PR. Endoscopic manometry of the sphincter of Oddi: its usefulness for the diagnosis and treatment of benign papillary stenosis [J]. Gastrointest Endosc, 1996, 43(5): 536538.
6.	吴高松, 邹声泉. Oddi括约肌运动功能异常的诊断与治疗 [J]. 中华肝胆外科杂志, 2003, 9(7): 442444.
7.	王永向, 吴涛, 纪宗正, 等. 胆囊切除术后奥狄括约肌功能障碍的内镜治疗 [J]. 中华消化内镜杂志, 2002, 19(1): 2123.
8.	董家鸿, 冷建军. Oddi括约肌功能障碍 [J]. 中国现代手术学杂志, 2002, 9(3): 164166.
9.	Frulloni L, Cavallini G. Acute recurrent pancreatitis and dysfunction of the sphincter of Oddi: comparison between invasive and noninvasive techniques [J]. JOP, 2001, 2(6): 406413.
10.	Testoni PA. Why the incidence of postERCP pancreatitis varies considerably? Factors affecting the diagnosis and the incidence of this complication [J]. JOP, 2002, 3(6): 195201.
11.	吴硕东, 金俊哲, 姜锡然, 等. 经胆道镜测压观察硝酸甘油等对Oddi括约肌的作用 [J]. 消化外科2002, 1(1): 4042.
12.	Staritz M. Pharmacology of the sphincter of Oddi [J]. Endoscopy, 1988, 20 Suppl 1: 171174.
13.	刘双, 刘军, 孙文生, 等. 硝酸甘油预防ERCP术后胰腺炎及高淀粉酶血症的临床应用研究 [J]. 中国普外基础与临床杂志, 2009, 16(8): 641644.
14.	Lai KH, Lo GH, Cheng JS, et al. Effect of somatostatin on the sphincter of Oddi in patients with acute nonbiliary pancreatitis [J]. Gut, 2001, 49(6): 843846.
15.	Németh AM. Somatostatin in the treatment of pancreatic diseases [J]. Orv Hetil, 2002, 143(19 Suppl): 10991108.
16.	Prajapati DN, Hogan WJ. Sphincter of Oddi dysfunction and other functional biliary disorders: evaluation and treatment [J]. Gastroenterol Clin North Am, 2003, 32(2): 601618.
17.	Sugawa C, Park DH, Lucas CE, et al. Endoscopic sphincterotomy for stenosis of the sphincter of Oddi [J]. Surg Endosc, 2001, 15(9): 10041007.
18.	Wehrmann T, Aharonoff H, Dietrich CF, et al. Do ultrasound parameters allow diagnosis of biliary sphincter of Oddi dysfunction? [J]. Z Gastroenterol, 1997, 35(6): 449457.
19.	Geenen JE, Hogan WJ, Dodds WJ, et al. Intraluminal pressure recording from the human sphincter of Oddi [J]. Gastroenterology, 1980, 78(2): 317324.
20.	杨维良, 张新晨. 十二指肠乳头良性狭窄治疗的术式选择与评价 [J]. 医师进修杂志(外科版), 2004, 27(20): 5759.
21.	全卓勇, 彭开勤, 张应天. Oddi括约肌切开成形术168例临床分析.中国实用外科杂志, 2002, 22(7): 411413.
22.	林擎天. 胆总管末端良性狭窄的诊断和治疗 [J]. 中华普通外科杂志, 1999, 14(3): 208210.
23.	Barthet M, Lesavre N, Desjeux A, et al. Complications of endoscopic sphincterotomy: results from a single tertiary referral center [J]. Endoscopy, 2002, 34(12): 991997.

1. Park SH, Watkins JL, Fogel EL, et al. Longterm outcome of endoscopic dual pancreatobiliary sphincterotomy in patients with manometrydocumented sphincter of Oddi dysfunction and normal pancreatogram [J]. Gastrointest Endosc, 2003, 57(4): 483491.
2. Sugiyama M, Atomi Y. Followup of more than 10 years after endoscopic sphincterotomy for choledocholithiasis in young patients [J]. Br J Surg, 1998, 85(7): 917921.
3. Hogan WJ, Geenen JE. Biliary dyskinesia [J]. Endoscopy, 1988, 20 Suppl 1: 179183.
4. BarMeir S, Halpern Z, Bardan E, et al. Frequency of papillary dysfunction among cholecystectomized patients [J]. Hepatology, 1984, 4(2): 328330.
5. Hawes RH, Tarnasky PR. Endoscopic manometry of the sphincter of Oddi: its usefulness for the diagnosis and treatment of benign papillary stenosis [J]. Gastrointest Endosc, 1996, 43(5): 536538.
6. 吴高松, 邹声泉. Oddi括约肌运动功能异常的诊断与治疗 [J]. 中华肝胆外科杂志, 2003, 9(7): 442444.
7. 王永向, 吴涛, 纪宗正, 等. 胆囊切除术后奥狄括约肌功能障碍的内镜治疗 [J]. 中华消化内镜杂志, 2002, 19(1): 2123.
8. 董家鸿, 冷建军. Oddi括约肌功能障碍 [J]. 中国现代手术学杂志, 2002, 9(3): 164166.
9. Frulloni L, Cavallini G. Acute recurrent pancreatitis and dysfunction of the sphincter of Oddi: comparison between invasive and noninvasive techniques [J]. JOP, 2001, 2(6): 406413.
10. Testoni PA. Why the incidence of postERCP pancreatitis varies considerably? Factors affecting the diagnosis and the incidence of this complication [J]. JOP, 2002, 3(6): 195201.
11. 吴硕东, 金俊哲, 姜锡然, 等. 经胆道镜测压观察硝酸甘油等对Oddi括约肌的作用 [J]. 消化外科2002, 1(1): 4042.
12. Staritz M. Pharmacology of the sphincter of Oddi [J]. Endoscopy, 1988, 20 Suppl 1: 171174.
13. 刘双, 刘军, 孙文生, 等. 硝酸甘油预防ERCP术后胰腺炎及高淀粉酶血症的临床应用研究 [J]. 中国普外基础与临床杂志, 2009, 16(8): 641644.
14. Lai KH, Lo GH, Cheng JS, et al. Effect of somatostatin on the sphincter of Oddi in patients with acute nonbiliary pancreatitis [J]. Gut, 2001, 49(6): 843846.
15. Németh AM. Somatostatin in the treatment of pancreatic diseases [J]. Orv Hetil, 2002, 143(19 Suppl): 10991108.
16. Prajapati DN, Hogan WJ. Sphincter of Oddi dysfunction and other functional biliary disorders: evaluation and treatment [J]. Gastroenterol Clin North Am, 2003, 32(2): 601618.
17. Sugawa C, Park DH, Lucas CE, et al. Endoscopic sphincterotomy for stenosis of the sphincter of Oddi [J]. Surg Endosc, 2001, 15(9): 10041007.
18. Wehrmann T, Aharonoff H, Dietrich CF, et al. Do ultrasound parameters allow diagnosis of biliary sphincter of Oddi dysfunction? [J]. Z Gastroenterol, 1997, 35(6): 449457.
19. Geenen JE, Hogan WJ, Dodds WJ, et al. Intraluminal pressure recording from the human sphincter of Oddi [J]. Gastroenterology, 1980, 78(2): 317324.
20. 杨维良, 张新晨. 十二指肠乳头良性狭窄治疗的术式选择与评价 [J]. 医师进修杂志(外科版), 2004, 27(20): 5759.
21. 全卓勇, 彭开勤, 张应天. Oddi括约肌切开成形术168例临床分析.中国实用外科杂志, 2002, 22(7): 411413.
22. 林擎天. 胆总管末端良性狭窄的诊断和治疗 [J]. 中华普通外科杂志, 1999, 14(3): 208210.
23. Barthet M, Lesavre N, Desjeux A, et al. Complications of endoscopic sphincterotomy: results from a single tertiary referral center [J]. Endoscopy, 2002, 34(12): 991997.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Analysis of 42 Patients with Sphincter of Oddi Dysfunction Treated by Endoscopic Sphincterotomy

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