title: Is endoscopic sphincterotomy avoidable in patients with sphincter of Oddi dysfunction?
abstract: OBJECTIVE
  Endoscopic sphincterotomy is an efficient means of treating sphincter of Oddi dysfunction (SOD), but it is associated with a morbidity rate of 20%. The aim of this study was to assess how frequently endoscopic sphincterotomy was performed to treat SOD in a group of patients with a 1-year history of medical management.
  
  
  METHODS
  A total of 59 patients, who had been cholecystectomized 9.3 years previously on average, were included in this study and they all underwent biliary scintigraphy. Medical treatment was prescribed for 1 year. Endoscopic sphincterotomy was proposed for patients whose medical treatment had been unsuccessful.
  
  
  RESULTS
  Eleven patients were rated group 1 on the Milwaukee classification scale, 34 group 2 and 14 group 3. The hile-duodenum transit time (HDTT) was lengthened in 32 patients. The medical treatment was efficient or fairly efficient in 45% of the group 1 patients, 67% of the group 2 patients, and 71.4% of the group 3 patients (P=0.29). Only 14 patients out of the 21 whose medical treatment was unsuccessful agreed to undergo endoscopic sphincterotomy. HDTT was lengthened in 11 of the 14 patients undergoing endoscopic sphincterotomy and in 21 of the 45 non-endoscopic sphincterotomy patients (P=0.03). Twelve of the 14 patients who underwent endoscopic sphincterotomy were cured.
  
  
  CONCLUSIONS
  In this prospective series of patients with a 1-year history of medical management, only 23% of the patients with suspected SOD underwent endoscopic sphincterotomy although 54% had an abnormally long HDTT.
authors: Department of Gastroenterology, Hôpital Nord, Chemin des Bourrely, Marseille cedex, France.
authors: Veronique
authors: V
authors: Vitton
authors: Rene
authors: R
authors: Delpy
authors: Mohamed
authors: M
authors: Gasmi
authors: Nathalie
authors: N
authors: Lesavre
authors: Einate
authors: E
authors: Abou-Berdugo
authors: Ariadne
authors: A
authors: Desjeux
authors: Jean-Charles
authors: JC
authors: Grimaud
authors: Marc
authors: M
authors: Barthet
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D046628:Sphincter of Oddi Dysfunction / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016717:Sphincterotomy, Endoscopic / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome