Management of patients with sphincter of Oddi dysfunction based on a new classification.
OBJECTIVE
To propose a new classification system for sphincter of Oddi dysfunction (SOD) based on clinical data of patients.


METHODS
The clinical data of 305 SOD patients documented over the past decade at our center were analyzed retrospectively, and typical cases were reported.


RESULTS
The new classification with two more types (double-duct, biliary-pancreatic reflux) were set up on the basis of the Milwaukee criteria. There were 229 cases of biliary-type SOD, including 192 (83.8%) cases cured endoscopically, and 29 (12.7%) cured by open abdominal surgery, and the remaining 8 (3.5%) cases observed with unstable outcomes. Eight (50%) patients with pancreatic-type SOD were cured by endoscopic treatment, and the remaining 8 patients were cured after open abdominal surgery. There were 19 cases of double-duct-type SOD, which consisted of 7 (36.8%) patients who were cured endoscopically and 12 (63.2%) who were cured surgically. A total of 41 cases were diagnosed as biliary-pancreatic-reflux-type SOD. Twenty (48.8%) of them were treated endoscopically, 16 (39.0%) were treated by open abdominal surgery, and 5 (12.2%) were under observation.


CONCLUSIONS
The newly proposed SOD classification system introduced in this study better explains the clinical symptoms of SOD from the anatomical perspective and can guide clinical treatment of this disease.
Jia-Qing Gong, Jian-Dong Ren, Fu-Zhou Tian, Li-Jun Tang, Yong Pang, Department of General Surgery, the People's Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sicuan Province, China.
Jia-Qing
JQ
Gong
Jian-Dong
JD
Ren
Fu-Zhou
FZ
Tian
Rui
R
Jiang
Li-Jun
LJ
Tang
Yong
Y
Pang
D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D009803:Sphincter of Oddi / Q000503:physiopathology* / Q000601:surgery; D046628:Sphincter of Oddi Dysfunction / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome
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