The incidence of post-sphincterotomy stenosis in group II patients with sphincter of Oddi dysfunction.
Patients with group II sphincter of Oddi dysfunction documented by elevated sphincter of Oddi pressure improve after endoscopic sphincterotomy. A large group II population was studied to determine the incidence of post-endoscopic sphincterotomy stenosis. Eighty-five patients (82 women and 3 men), ages 21 to 88 years (mean, 50 years), fulfilled the clinical criteria for group II sphincter of Oddi dysfunction; each had an elevated basal sphincter of Oddi pressure (> or = 40 mm Hg), and received endoscopic sphincterotomy. These patients were observed for a mean of 7 +/- 3 years. Four patients re-presented with clinical findings suggestive of recurrent sphincter of Oddi dysfunction; all were found to have a basal sphincter of Oddi pressure greater than or equal to 40 mm Hg. Symptoms re-developed within 4 months after endoscopic sphincterotomy (mean, 3.3 months). Endoscopic sphincterotomy was repeated in all four patients with one endoscopically treated complication. On 25-month mean follow-up, none of the patients had further signs or symptoms of papillary stenosis. Endoscopic sphincterotomy in patients with group II sphincter of Oddi dysfunction is associated with a low incidence of restenosis (4.7%). Repeat endoscopic sphincterotomy was found to be effective management in patients with papillary restenosis.
Manoukian
A V
AV
St. Luke's Hospital, Racine, Wisconsin.
Schmalz
M J
MJ
Geenen
J E
JE
Hogan
W J
WJ
Venu
R P
RP
Johnson
G K
GK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002779:Cholestasis / Q000503:physiopathology / Q000601:surgery; D003137:Common Bile Duct Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D012008:Recurrence; D009803:Sphincter of Oddi / Q000503:physiopathology*; D016717:Sphincterotomy, Endoscopic