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Sphincter of Oddi dysfunction pressures high

Mohammad Yaghoobi, Qi Pauls, Valerie Durkalski, Joseph Romagnuolo, Evan L Fogel, Paul R Tarnasky, Giuseppe Aliperti, Martin L Freeman, Richard A Kozarek, Priya A Jamidar, Charles M Wilcox, Grace H Elta, Robert H Hawes, April Wood-Williams, Peter B Cotton
BACKGROUND AND STUDY AIM: Pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) is a significant and potentially life-threatening adverse event and is common in patients with suspected sphincter of Oddi dysfunction (SOD). Here we aimed to identify predictors of the risk in this population. PATIENTS AND METHODS: The Evaluating Predictors and Interventions in SOD (EPISOD) study prospectively enrolled 214 post-cholecystectomy patients with SOD type III in seven US centers...
October 2015: Endoscopy
Saori Kakuyama, Kentaro Nobutani, Atsuhiro Masuda, Hideyuki Shiomi, Tsuyoshi Sanuki, Maki Sugimoto, Masaru Yoshida, Yoshifumi Arisaka, Tsuyoshi Fujita, Takanobu Hayakumo, Takeshi Azuma, Hiromu Kutsumi
BACKGROUND: Sphincter of Oddi manometry (SOM) is recognized as the standard diagnostic modality for sphincter of Oddi dysfunction (SOD). However, SOM is not commonly performed because of its technical difficulty and the high incidence of post-procedural pancreatitis. To diminish post-procedural pancreatitis, we tried to develop a new method of SOM. This study examined the feasibility of SOM with a guide-wire-type manometer, which is commonly used to measure the arterial pressure for coronary angiography, for the assessment of SO motility...
October 2013: Journal of Gastroenterology
K J Roberts, A Ismail, C Coldham, J Buckels, S Bramhall
INTRODUCTION: Surgical sphincteroplasty (SS) for sphincter of Oddi dysfunction (SOD) can be performed primarily or following failed endoscopic therapy. The role of SS in an era of endoscopic management is unclear. This study presents long-term follow-up of patients who had undergone SS at a tertiary referral unit. METHODS: Patients were identified from a departmental database and sent post-operative questionnaires to review pain scores and satisfaction with the procedure...
2011: Digestive Surgery
Wence Zhou, Yumin Li, Quanbao Zhang, Xun Li, Wenbo Meng, Lei Zhang, Hui Zhang, Kexiang Zhu, Xiaoliang Zhu
BACKGROUND AND AIMS: Postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) is one of the most common and serious complications after endoscopic retrograde cholangiopancreatography (ERCP). This study aims to test the hypothesis that the incidence of PEP declined over time due to improved patient selection and/or endoscopic equipment and endoscopic techniques. Therefore, we compared the incidence and risk factors of PEP between four arbitrary chronologically stratified groups...
2011: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
John P Rice, Bret J Spier, Deepak V Gopal, Anurag Soni, Mark Reichelderfer, Patrick R Pfau
Background. Sphincter of Oddi manometry is a highly specialized procedure associated with an increased risk of procedural complications. Published studies have typically been performed in large volume manometry centers. Objective. To examine the outcomes and complication rate of SOM when performed in small volumes. Design. Retrospective analysis at a tertiary care referral hospital that infrequently performs Sphincter of Oddi manometry. Patient records were reviewed for procedural details, patient outcomes, and complications after sphincter of Oddi manometry...
2011: Diagnostic and Therapeutic Endoscopy
M A Khashab, J L Watkins, L McHenry, L Lazzell-Pannell, S Schmidt, S Sherman, G A Lehman, E L Fogel
BACKGROUND AND STUDY AIMS: Sphincter of Oddi manometry (SOM), performed at endoscopic retrograde cholangiopancreatography (ERCP), is the gold standard for diagnosing sphincter of Oddi dysfunction (SOD). The question remains as to whether the short-term manometric recordings reflect the 24-hour pathophysiology of the sphincter. The aim of this study was to determine the frequency of SOD in persistently symptomatic patients with previously normal SOM studies. PATIENTS AND METHODS: All patients who underwent ERCP for suspected SOD over a 13-year period (1994 - 2007) were considered for inclusion in the study...
May 2010: Endoscopy
Ding Siqin, Cun Wang, Zongguang Zhou, Yuan Li
Acute pancreatitis (AP) is an acute inflammatory disease of the pancreas. Severe acute pancreatitis (SAP) is the serious forms of AP with high mortality rate. However, the frequency of SAP remains stable over time. Biliary calculi and alcohol abuse are the most common causes of AP. Other causes such as iatrogenic factors, sphincter of Oddi dysfunction (SOD) and eating disorders also cannot be omitted. Blockage of duodenal papilla or ampulla of Vater is common characteristics of AP. Once the blockage appears, the occurrence of pancreatic duct obstruction and bile reflux is inevitable...
May 2009: Medical Hypotheses
Masahiko Kawamoto, Joseph Geenen, Taher Omari, Ann C Schloithe, Gino T P Saccone, James Toouli
BACKGROUND/PURPOSE: Perfused multilumen sphincter of Oddi (SO) manometry is accepted as the gold standard for diagnosis of SO dysfunction. However, this technique is associated with a relatively high incidence of post-procedure acute pancreatitis. In addition, triple-lumen manometry recordings may be difficult to interpret, as movement may produce artifacts. We have refined the development of a sleeve sensor for human SO manometry. This assembly aims to overcome the above limitations...
2008: Journal of Hepato-biliary-pancreatic Surgery
Xiao-Yong Zhang, Guang-Bin Cui, Ke-Jun Ma, Sha Wang, Ya-Ning Wei, Pang Du, Bao-Ying Chen, Wei Guo, Xin-Jiang Wang, Hai-Dong Huang, Jian-Hong Wang, Xiao-Feng Huang, Chun-Mei Wang, Yue-Min Wang, Jing-Guo Wei
BACKGROUND AND OBJECTIVES: The mechanisms that trigger gallbladder evacuation dysfunction, the key risk factor for gallstone formation, have not yet been fully elucidated. The sphincter of Oddi (SO) plays important roles in the regulation of gallbladder evacuation and maintenance of normal hydraulic pressure of the biliary tract. The aim of our study was to investigate the effects of hypercholesterolemia on the motility function of SO and the underlying mechanisms of SO dysfunction (SOD)...
March 2008: European Journal of Gastroenterology & Hepatology
P Sandstrom, C M Woods, M Brooke-Smith, G T P Saccone, J Toouli, J Svanvik
AIM: Inducible nitric oxide synthase (iNOS) plays a major role in acute pancreatitis. Selective inhibitors of iNOS are being developed as therapeutic agents. Sphincter of Oddi (SO) dysfunction may cause pancreatitis and nitric oxide is necessary for SO relaxation. A new highly selective iNOS inhibitor, AR-C102222AA (AR-C), is evaluated together with the established iNOS inhibitor, L-N(6)-(1-iminoethyl)lysine (L-NIL), and the selective neuronal nitric oxide synthase (nNOS) blocker S-methyl-l-thiocitrulline (SMTC)...
July 2004: Acta Physiologica Scandinavica
Kinnari Kher, Moises Guelrud
With the introduction of endoscopic retrograde cholangiopancreatography (ERCP) manometry, the characteristics of sphincter of Oddi (SO) motor activity have been described. SO manometry is the only available method to measure SO motor activity directly and is usually performed at the time of ERCP. SO manometry is considered to be the gold standard for evaluating patients for sphincter dysfunction. This review reports the technique of SO manometry and normal values for SO manometry. SO motility is characterized by prominent phasic contractions superimposed on a tonic pressure...
April 2004: Current Gastroenterology Reports
Junichi Yoshikawa, Jun Matsumoto, Terukatsu Arima
Diagnostic ability of endoscopic sphincter of oddi manometry for 112 patients with biliopancreatic diseases (including 12 patients of normal) was evaluated. The presence of abnormal high pressure was recognized in 50% of suspected sphincter of oddi dysfunction (SOD). 56% of cholecystolithiasis, 67% of cholecystocholedocholithiasis and 50% of pancreatic stones. Many patients with abdominal pain of suspected SOD or stones of biliopancreatic ducts were considered to have possibility of the complication of papillary stenosis...
February 2004: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
A Gorelick, J Barnett, W Chey, M Anderson, G Elta
BACKGROUND AND STUDY AIMS: Endoscopic biliary sphincterotomy in patients with sphincter of Oddi dysfunction (SOD) is associated with a high risk of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP), which may be secondary to residual pancreatic sphincter hypertension. It was hypothesized that botulinum toxin injection could be used to reduce pancreatic sphincter hypertension temporarily in SOD patients after biliary sphincterotomy, thereby reducing the rate of procedure-induced pancreatitis...
February 2004: Endoscopy
Shyam Varadarajulu, Robert H Hawes, Peter B Cotton
BACKGROUND: Assessment of sphincter of Oddi motility by manometry is limited to a finite time period, and the presence of a motor disorder that is intermittent may not be documented. This study evaluated the frequency of sphincter of Oddi dysfunction in persistently symptomatic patients with previously normal sphincter of Oddi manometry studies. METHODS: A total of 177 patients underwent ERCP for suspected sphincter of Oddi dysfunction and had a normal sphincter of Oddi manometry study (both biliary and pancreatic) over a 5-year period (1996-2001)...
September 2003: Gastrointestinal Endoscopy
Jeffrey D Linder, Wilma Geels, C Mel Wilcox
Recent studies suggest a high prevalence of sphincter of Oddi dysfunction (SOD) in patients referred to specialized centers for sphincter of Oddi manometry (SOM). Whether these results can be generalized to other centers is unknown. From September 1998 to April 2000, patients undergoing SOM were prospectively identified. Patients were classified as having either biliary or pancreatic SOD, according to the modified Milwaukee classification, and underwent SOM of either the biliary or pancreatic sphincter based on clinical history...
November 2002: Digestive Diseases and Sciences
Sergio Zepeda-Gómez, Miguel Angel Valdovinos-Díaz
Botulinum toxin (Botox) produced by Clostridium botulinum is a potent neuromuscular blocker agent that inhibits acetylcholine release from presynaptic nerve endings. This effect was confirmed in the smooth muscle of the gastrointestinal tract and led to clinical trials investigating the efficacy of Botox for treatment of several gastrointestinal disorders. Multiple controlled studies have shown that Botox is effective in short-term management of achalasia. Botox reduces lower esophageal sphincter pressure, improves esophageal clearance, and alleviates symptoms in up to 70% of patients; however, its long-term efficacy decreases to 30% and repeated injections are often necessary...
April 2002: Revista de Gastroenterología de México
E L Fogel, D Eversman, P Jamidar, S Sherman, G A Lehman
BACKGROUND AND STUDY AIMS: Patients with suspected or documented sphincter of Oddi dysfunction (SOD) who undergo standard biliary sphincterotomy have high rates of post-procedure pancreatitis. Approximately 75% of such patients have elevated basal pressures of the pancreatic sphincter. Biliary sphincterotomy (BES) on its own leaves the pancreatic sphincter unablated and may cause transient edema which aggravates the increase in pancreatic sphincter pressure. Combined pancreaticobiliary therapy (PBR), using pancreatic stenting in addition to sphincterotomy may therefore be safer...
April 2002: Endoscopy
K H Lai, G H Lo, J S Cheng, M T Fu, E M Wang, H H Chan, Y Y Wang, P I Hsu, C K Lin
BACKGROUND: Somatostatin has been used to prevent pancreatitis after endoscopic retrograde cholangiopancreatography but its effect on acute non-biliary pancreatitis is still unclear. AIM: The purpose of this study was to evaluate the function of the sphincter of Oddi (SO) and the effect of somatostatin on patients with non-biliary pancreatitis. METHODS: Twenty patients (18 males, two females) with acute pancreatitis (alcoholic 18, idiopathic two) received SO manometry within one week after admission...
December 2001: Gut
R R Aymerich, C Prakash, G Aliperti
BACKGROUND: Data are scant on the miss rate of sphincter of Oddi dysfunction if basal pressure in both biliary and pancreatic sphincter segments is not measured during manometry. METHODS: Motility tracings with basal pressure measurements of both sphincter segments were retrospectively analyzed. Basal sphincter pressure greater than 40 mm Hg was considered abnormal in either sphincter segment. RESULTS: The study population consisted of 73 subjects (64 women, 9 men; age 45...
August 2000: Gastrointestinal Endoscopy
T Wehrmann, T Schmitt, A Schönfeld, W F Caspary, H Seifert
BACKGROUND AND STUDY AIMS: Endoscopic perfusion manometry (PM) of the sphincter of Oddi (SO) requires expensive equipment which is relatively large and uncomfortable to handle in the endoscopic retrograde cholangiopancreatography (ERCP) setting. Furthermore, the volume load of the biliopancreatic system may contribute to the increased risk of pancreatitis after SO manometry. PATIENTS AND METHODS: The newly developed small and lightweight microtransducer system consists of a portable data-logger with integrated online display which is connected to a 4-Fr manometry probe...
June 2000: Endoscopy
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