The sphincter of Oddi and acute pancreatitis--revisited.
BACKGROUND
One of the rare causes of recurrent acute pancreatitis is sphincter of Oddi dysfunction. This condition is objectively diagnosed by manometry of the sphincter of Oddi. An abnormally elevated sphincter of Oddi basal pressure has been shown to predict patients who have a successful outcome after transduodenal sphincteroplasty and pancreatic duct septoplasty.


METHODS
Forty-nine patients presenting with recurrent pancreatitis and who had manometric stenosis of the sphincter of Oddi were treated by transduodenal division of the sphincter of Oddi. Clinical follow-up was conducted over a minimum of 2 years.


RESULTS
In all, 43 patients were either cured or improved. None of these patients had any further episodes of pancreatitis. Three of these patients developed recurrent symptoms and were noted to have restenosis of the sphincter of Oddi. They were treated by insertion of an endoscopic stent into the pancreatic duct.


CONCLUSIONS
The results from this series of patients re-affirm the efficacy of transduodenal sphincteroplasty and septoplasty for treatment of sphincter of Oddi stenosis in patients presenting with recurrent acute pancreatitis.
Toouli
J
J
Department of General and Digestive Surgery, Flinders Medical Centre, South Australia, Australia. jim.toouli@flinders@edu.au