The efficacy of endoscopic sphincterotomy after cholecystectomy in patients with sphincter-of-Oddi dysfunction

Article Abstract:

After surgical gallbladder removal some patients experience pain due to an obstruction of the sphincter of Oddi, which can be treated by sphincterotomy. A double-blind study of 47 patuents was conducted in which 23 patients underwent sphincterotomy and 24 underwent a sham procedure. Pain scores improved in 10 of 11 patients with elevated sphincter pressure who underwent the actual procedure, as compared to three out of 12 patients with elevated pressure who underwent the sham procedure. Manometry was used to verify sphincter-of-Oddi dysfunction. After one year a group of 12 patients who had originally undergone the sham procedure underwent actual sphincterotomy. Five of these patients had normal sphincter presuure and seven had elevated sphincter pressure. Of the group, seven experienced relief. Overall, 17 of 18 patients with manometrically verified sphincter-of-Oddi dysfunction benefitted from sphincterotomy. Patients with normal pressure had no more benefit from the actual than from the sham procedure. Observation suggests that sphincterotomy is beneficial for long-term pain relief in patients with sphincter-of-Oddi dysfunction.

Research, Case studies, Abnormalities, Gastroenterology, Sphincter of Oddi, Oddi's sphincter

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Complications of endoscopic biliary sphincterotomy

Article Abstract:

The risk of complications from endoscopic biliary sphincterotomy appears to vary depending on the reason for performing the technique and the skill of the surgeon. This technique is used primarily to remove stones in the bile ducts. In a review of 2,347 patients who had this procedure, almost 10% had a complication. More than half developed pancreatitis and about one-quarter began hemorrhaging. Fifty-five died within 30 days and in 10 cases, the death was a result of the procedure. Risk factors for complications included dysfunction of the sphincter of Oddi and cirrhosis. The difficulty of the procedure was also a risk factor.

Risk factors, Surgery

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Complications of endoscopic sphincterotomy and their prevention

Article Abstract:

Complications from endoscopic retrograde cholangiopancreatography (ERCP) can be avoided by restricting the procedure to those most likely to benefit and using the most experienced physicians to perform the procedure. ERCP is used to diagnose and treat disorders of the pancreas and bile ducts. However, complications occur in up to 10% of all patients. A 1996 study found that complication rates varied with the skill of the physician and the type of disease the patient had. Another study found that a drug called gabexate might lower the incidence of pancreatitis after ERCP.

Editorial, Diagnosis, Prevention, Endoscopic retrograde cholangiopancreatography

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