title: [Risk factors in endoscopic manometry for suspected dysfunction of Oddi's sphincter].
abstract: OBJECTIVE
  An increased incidence of pancreatitis having been reported after endoscopic manometry (EM) of the sphincter of Oddi, its incidence and severity as well as potential risk factors were investigated prospectively.
  
  
  METHODS
  Between June 1988 and June 1996, standardised manometry was performed in 207 patients with suspected biliary and 23 with suspected pancreatic sphincter of Oddi dysfunction (SOD). All patients had been observed in hospital for at least 24 hours before the test. The diagnostic criteria of post-manometric pancreatitis (PMP) were epigastric pain and a rise in the concentration of serum amylase to at least three times normal. Potential risk factors for PMP were elucidated by uni- and multivariate analysis.
  
  
  RESULTS
  Pancreatitis occurred in 19 patients (9%) with suspected biliary and in 6 (26%) with suspected pancreatic SOD (P < 0.01), 17 of mild and 8 of moderate degree. There were no deaths and no lasting sequelae. Previous pancreatitis after endoscopic retrograde cholangiopancreatography and the presence of SOD were identified as patient-associated risk factors (P < 0.01 for each). Method-associated risk factors were duration of manometry of more than 5 min (P < 0.05) and manometry in the pancreatic duct system (P < 0.05). The risk of pancreatitis was reduced by simultaneous endoscopic sphincterotomy for SOD (P < 0.01).
  
  
  CONCLUSIONS
  Specific and often avoidable risk factors for postmanometric pancreatitis were identified: technical procedure, pancreatitis, SOD. With short duration of manometry, avoiding of manometry in the pancreatic duct system and with patient's informed consent for simultaneous endoscopic sphincterotomy risk of pancreatitis may be lowered.
authors.affiliation: Medizinische Klinik II, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main.
authors.forename: T
authors.initials: T
authors.lastname: Wehrmann
authors.forename: O G
authors.initials: OG
authors.lastname: Wendler
authors.forename: M
authors.initials: M
authors.lastname: Jung
authors.forename: W F
authors.initials: WF
authors.lastname: Caspary
mesh_terms: D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D003137:Common Bile Duct Diseases / Q000503:physiopathology*; D003627:Data Interpretation, Statistical; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000009:adverse effects; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D011312:Pressure; D011446:Prospective Studies; D012307:Risk Factors; D009803:Sphincter of Oddi / Q000503:physiopathology*; D016717:Sphincterotomy, Endoscopic; D013997:Time Factors
vernacular_title: Risikofaktoren der endoskopischen Manometrie bei Verdacht auf Sphinkter-Oddi-Dysfunktion.