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Sphincter of oddi dysfunction

Paul R Tarnasky
Post-cholecystectomy syndrome and the concept of a causal relationship to sphincter of Oddi dysfunction, despite the controversy, has presented a clinically relevant conflict for decades. Historically surgeons, and now gastroenterologists have expended tremendous efforts towards trying to better understand the dilemma that is confounded by unique patient phenotypes. Areas Covered: This review encompasses the literature from a century of experience on the topic of post-cholecystectomy syndrome. Relevant historical and anecdotal experiences are examined in the setting of insights from evaluation of recently available controlled data...
October 20, 2016: Expert Review of Gastroenterology & Hepatology
Rabindra R Watson, Jason Klapman, Srinadh Komanduri, Janak N Shah, Sachin Wani, Raman Muthusamy
BACKGROUND: Sphincter of Oddi manometry (SOM) is recommended in the evaluation of suspected Type II sphincter of Oddi dysfunction (SOD2), though its utility is uncertain. Little is known about the practice of expert endoscopists in the United States regarding SOD2. METHODS: An anonymous electronic survey was distributed to 128 expert biliary endoscopists identified from U.S. advanced endoscopy training programs. RESULTS: The response rate was 46...
September 2016: Endoscopy International Open
Fernanda de Quadros Onófrio, Julio Carlos Pereira Lima, Guilherme Watte, Romnei Lenon Lehmen, Daniela Oba, Gabriela Camargo, Carlos Eduardo Oliveira Dos Santos
Background Acute pancreatitis is the most common complication after ERCP, occurring in about 4 % of the procedures. Only the placement of pancreatic duct prosthesis and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) have shown benefit in the prevention of post-ERCP pancreatitis (PEP). Although the benefit of rectal administration of indomethacin or diclofenac is recommended by some studies and society guidelines especially in a selected group of high-risk patients, there is so far, no standardization of time or route of NSAID administration...
September 20, 2016: Surgical Endoscopy
David Zagalsky, Martin Alejandro Guidi, Cecilia Curvale, Juan Lasa, Julio de Maria, Hernan Ianniccillo, Hui Jer Hwang, Raúl Matano
BACKGROUND: The most common adverse event of endoscopic retrograde cholangiopancreatography is pancreatitis. Precut sphincterotomy has been regarded as a risk factor. Some authors have stated that early precut may actually reduce post-ERCP pancreatitis risk. However, early precut as a preventive measure has not been compared to other preventive measures, such as pancreatic duct stent placement. AIM: To compare the efficacy of early precut sphincterotomy versus pancreatic duct stent placement in high-risk subjects undergoing endoscopic retrograde cholangiopancreatography for the prevention of post-endoscopic cholangiopancreatography...
September 2016: Revista Española de Enfermedades Digestivas
Kondal Rao Kyanam Kabir Baig, Charles Melbern Wilcox
Sphincter of Oddi dysfunction is a complex pathophysiologic entity that is associated with significant morbidity causing abdominal pain, nausea, and vomiting. The purpose of this review is to describe the anatomy and physiology of the sphincter of Oddi, to understand the pathologic mechanisms thought to be responsible for symptomatology, review recent major studies, explore endoscopic and pharmacologic therapies and their efficacy, and to explore future research avenues.
2016: Clinical and Experimental Gastroenterology
Vishal Sharma, Surinder Singh Rana, Vinita Chaudhary, Narendra Dhaka, Manish Manrai, Jegan Sivalingam, Ravi Sharma, Usha Dutta, Deepak Kumar Bhasin
Double duct sign where there is a simultaneous dilatation of both the common bile duct (CBD) and pancreatic duct is usually associated with sinister causes like malignancies of pancreatic head or ampulla. Occasionally, benign causes like chronic pancreatitis or sphincter of Oddi dysfunction (SOD) may cause double duct sign. Chronic opium abuse is a rare cause of the double duct sign, and endoscopic ultrasound (EUS) findings of this rare entity have been occasionally reported. We report about a 54-year-old male with a history of chronic alcohol and opioid abuse evaluated for episodes of abdominal pain and found to have opioid-related SOD and improved with biliary sphincterotomy...
July 2016: Endoscopic Ultrasound
Tilak Shah, Alvin Zfass, Mitchell L Schubert
No abstract text is available yet for this article.
September 2016: Digestive Diseases and Sciences
Piyush Somani Md, Udayakumar Navaneethan Md
Recurrent acute pancreatitis (RAP) is defined based on the occurrence of two or more episodes of acute pancreatitis. RAP is differentiated from chronic pancreatitis based on the presence of a normal morphological appearance of the pancreas between episodes. RAP can be due to a variety of etiologies including common bile duct stones or sludge, sphincter of Oddi dysfunction (SOD), pancreas divisum (PD), anomalous pancreaticobiliary junction, genetic mutations, and alcohol related. In approximately 30 % of patients, the etiology of RAP is unclear and the term "idiopathic" is used...
September 2016: Current Treatment Options in Gastroenterology
Zhong-Hou Rong, Hong-Yuan Chen, Xin-Xing Wang, Zhi-Yi Wang, Guo-Zhe Xian, Bang-Zhen Ma, Cheng-Kun Qin, Zhen-Hai Zhang
AIM: To investigate the mechanisms and effects of sphincter of Oddi (SO) motility on cholesterol gallbladder stone formation in guinea pigs. METHODS: Thirty-four adult male Hartley guinea pigs were divided randomly into two groups, the control group (n = 10) and the cholesterol gallstone group (n = 24), which was sequentially divided into four subgroups with six guinea pigs each according to time of sacrifice. The guinea pigs in the cholesterol gallstone group were fed a cholesterol lithogenic diet and sacrificed after 3, 6, 9, and 12 wk...
June 28, 2016: World Journal of Gastroenterology: WJG
C Mel Wilcox, Toni Seay, Hwasoon Kim, Shyam Varadarajulu
OBJECTIVES: Although idiopathic pancreatitis is common, the natural history is not well studied, and the best diagnostic approach to both single and multiple attacks remains undefined. METHODS: We prospectively evaluated patients with idiopathic pancreatitis over a 10-year period, and clinical information for each episode was reviewed. Endoscopic ultrasound (EUS) was performed in all patients. Patients with microlithiasis or bile duct stones were referred for cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP), respectively...
September 2016: American Journal of Gastroenterology
Pier Alberto Testoni, Alberto Mariani, Lars Aabakken, Marianna Arvanitakis, Erwan Bories, Guido Costamagna, Jacques Devière, Mario Dinis-Ribeiro, Jean-Marc Dumonceau, Marc Giovannini, Tibor Gyokeres, Michael Hafner, Jorma Halttunen, Cesare Hassan, Luis Lopes, Ioannis S Papanikolaou, Tony C Tham, Andrea Tringali, Jeanin van Hooft, Earl J Williams
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE suggests that difficult biliary cannulation is defined by the presence of one or more of the following: more than 5 contacts with the papilla whilst attempting to cannulate; more than 5 minutes spent attempting to cannulate following visualization of the papilla; more than one unintended pancreatic duct cannulation or opacification (low quality evidence, weak recommendation)...
July 2016: Endoscopy
Qi Pauls, Valerie Durkalski-Mauldin, Olga Brawman-Mintzer, Chris Lawrence, Rebekah Whichard, Peter B Cotton
OBJECTIVE: To examine the tolerability and efficacy of duloxetine in patients with suspected sphincter of Oddi dysfunction (SOD). METHODS: An open-label, single-center, 12-week trial of duloxetine 60 mg once daily was conducted in 20 patients with suspected SOD. All patients were evaluated by expert pancreato-biliary specialists. The primary outcome measure was a Patient Global Impression of Change (PGIC) scale. Secondary measures included the pain burden, assessed by the Recurrent Abdominal Pain Intensity and Disability scale, the Short-Form Health Survey, and the Hospital Anxiety and Depression Scale...
September 2016: Digestive Diseases and Sciences
P B Cotton, G H Elta, C R Carter, P J Pasricha, E S Corazziari
The concept that motor disorders of the gallbladder, cystic duct and sphincter of Oddi can cause painful syndromes is attractive and popular, at least in the USA. However, the results of commonly performed ablative treatments (cholecystectomy and sphincterotomy) are not uniformly good. The predictive value of tests that are often used to diagnose dysfunction (dynamic gallbladder scintigraphy and sphincter manometry) is controversial. Evaluation and management of these patients is made difficult by the fluctuating symptoms and the placebo effect of invasive interventions...
February 19, 2016: Gastroenterology
Lesley A Houghton, Margaret Heitkemper, Michael Crowell, Anton Emmanuel, Albena Halpert, James A McRoberts, Brenda Toner
Patients with functional gastrointestinal disorders (FGIDs) often experience distress, reduced quality of life, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework is implemented with the consideration of important factors that impact FGIDs, such as gender, age, society, and the patient's perspective...
February 15, 2016: Gastroenterology
G A Mejía, C Olarte-Parra, A Pedraza, J B Rivera, C A Benavides
INTRODUCTION: Biliary complications (BC) are one of the most frequent surgical complications after liver transplantation. They include biliary stenosis, leaks, choledocolitiasis and sphincter of Oddi dysfunction. These complications can cause graft dysfunction, retrasplantation, or even death. The purpose of this study was to identify factors related to BC. MATERIALS AND METHODS: The medical records of all adult patients who underwent their first liver transplantation in our institution from 2005 to 2013 were reviewed, and any BC that required management was recorded...
March 2016: Transplantation Proceedings
M D Levin, Z Korshun, G Mendel'son
AIM: to investigate the duodenal motility on the basis of radiological studies. PATIENTS AND METHODS: We tested our hypothesis that sphincters of Kapandji and Ochsner are contracted in response to stimulation of duodenum by hydrochloric acid. These sphincters are not found in standard X-ray studies because barium does not contain hydrochloric acid when it coming from the stomach into the duodenum. The retrospective analysis of radiological studies of the upper digestive tract of 116 patients aged 55 to 92 years was done...
2016: Terapevticheskiĭ Arkhiv
M V Repin, V Yu Mikryukov, N M Pleshkova
OBJECTIVE: to diagnose and estimate the clinical value of postcholecystectomy sphincter of Oddi dysfunction in patients. MATERIAL AND METHODS: Examinations were made in 100 postcholecystectomy patients without signs of cholestasis; of them 14 postpapillotomy patients formed a comparison group. Hepatobiliary scintigraphy using the radiotracer 99mTC-bromeside was performed for 90 minutes with cholagogue breakfast at 45 minutes. Common bile duct and duodenal functions and duodenogastric reflux (DGR) were evaluated comparing them with clinical, laboratory, and instrumental findings...
November 2015: Vestnik Rentgenologii i Radiologii
Alejandro L Suarez, Qi Pauls, Valerie Durkalski-Mauldin, Peter B Cotton
BACKGROUND/AIMS: The reproducibility of sphincter of Oddi manometry (SOM) measurements and results of SOM after sphincterotomy has not been studied sufficiently. The aim of our study is to evaluate the reproducibility of SOM and completeness of sphincter ablation. METHODS: The recently published Evaluating Predictors and Interventions in sphincter of Oddi dysfunction (EPISOD) study included 214 subjects with post-cholecystectomy pain, and fit the criteria of sphincter of Oddi dysfunction type III...
July 30, 2016: Journal of Neurogastroenterology and Motility
Hong-Tian Xia, Jing Wang, Tao Yang, Bin Liang, Jian-Ping Zeng, Jia-Hong Dong
To determine the causes underlying the formation of adult choledochal cyst.Anomalous pancreaticobiliary junction is the most widely accepted theory regarding the etiology of choledochal cyst. However, choledochal cysts have been found in patients in the absence of this anomaly. Because the number of adult patients with choledochal cyst is increasing, it is important to address this controversy.Bile amylase levels in the cysts of 27 patients (8 males and 19 females) who had undergone cholecystectomy were retrospectively evaluated...
November 2015: Medicine (Baltimore)
Ali A Siddiqui, Devi Patel, Jeremy Kaplan, Andrew H Zabolotsky, David Loren, Thomas Kowalski, Saad S Ghumman, Douglas G Adler, Satish Munigala, Umar Hayat, Mohamad A Eloubeidi
No abstract text is available yet for this article.
November 2015: Digestive Diseases and Sciences
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