Pancreatic sphincter basal pressure after endoscopic or surgical pancreatic sphincter ablation

Sherman, S; Madura, James A.; Fogel, E. L.; Eversman, D.; Bucksot, Lois; Baute, P.; Flueckiger, Joyce

doi:10.1016/s0016-5107(97)80493-2

Cited by 2 publications

(2 citation statements)

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“…While of scientific interest, this documentation would require manometry on asymptomatic patients. The present authors performed manometry on 89 patients with persistent or recurrent pain or pancreatitis after surgical or endoscopic sphincterotomy (22). Table 6 shows that surgical sphincteroplasty was more effective than endoscopic sphincteroplasty in lowering basal sphincter pressure into the normal range.…”

Section: Efficacy Of Pancreaticmentioning

confidence: 92%

Hypertensive Pancreatic Sphincter

Lehman

Sherman

1998

Canadian Journal of Gastroenterology and Hepatology

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Major papilla pancreatic sphincter dysfunction, a variant of sphincter of Oddi dysfunction, causes pancreatitis or pancreatic-type pain. Endoscopic manometry as performed at endoscopic retrograde cholangiography is the most commonly used method to identify sphincter dysfunction. Noninvasive testing, such as secretin-stimulated ultrasound analysis of duct diameter, is less reliable and of relatively low sensitivity. Two-thirds of patients with sphincter of Oddi dysfunction have elevated pancreatic basal sphincter pressure. Patients with suspected or documented sphincter of Oddi dysfunction may respond to biliary sphincterotomy alone, but warrant evaluation of their pancreatic sphincter if symptoms persist after therapy. Whether such pancreatic and biliary sphincters should be treated at the first treatment session is controversial. Pancreatic sphincterotomy is associated with a complication rate very similar to that of biliary sphincterotomy except that the pancreatitis rate is two- to fourfold higher. Prophylactic pancreatic stenting diminishes such pancreatitis by approximately 50%.

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Section: Efficacy Of Pancreaticmentioning

confidence: 92%

Hypertensive Pancreatic Sphincter

Lehman

Sherman

1998

Canadian Journal of Gastroenterology and Hepatology

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“…We performed manometry on 89 patients with persistent or recurrent pain or pancreatitis after surgical pancreatic sphincteroplasty or endoscopic pancreatic sphincterotomy [33]. Surgical sphincteroplasty was more effective in lowering basal sphincter pressure into the normal range.…”

Section: Failure To Achieve Symptom Relief After Pancreatic Sphinctermentioning

confidence: 99%

Sphincter of oddi (pancreatic) hypertension and recurrent pancreatitis

Devereaux

Sherman

Lehman

2002

Curr Gastroenterol Rep

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Major papilla pancreatic sphincter dysfunction, a variant of sphincter of Oddi dysfunction, causes pancreatitis and pancreatic-type pain. The gold standard for diagnosis is sphincter of Oddi manometry, most commonly performed at endoscopic retrograde cholangiopancreatography (ERCP). Noninvasive testing, such as secretin-stimulated transabdominal or endoscopic ultrasound assessment of pancreatic duct diameter, is less reliable and has relatively low sensitivity. Two thirds of patients with biliary sphincter of Oddi dysfunction have elevated pancreatic basal sphincter pressure. To maximize the diagnostic yield of sphincter of Oddi dysfunction, both the biliary and pancreatic sphincter pressures should be measured. Patients with sphincter of Oddi dysfunction may respond to biliary sphincterotomy alone, but evaluation of their pancreatic sphincter is warranted if symptoms persist after biliary therapy alone. Whether both biliary and pancreatic sphincters should be treated at the first ERCP session is controversial. Biliary and pancreatic endoscopic sphincterotomies are associated with two- to fourfold increased incidence of pancreatitis following the procedure in patients with pancreatic sphincter hypertension. Prophylactic pancreatic duct stenting reduces the frequency and severity of complications by greater than 50%.

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Pancreatic sphincter basal pressure after endoscopic or surgical pancreatic sphincter ablation

Cited by 2 publications

References 0 publications

Hypertensive Pancreatic Sphincter

Hypertensive Pancreatic Sphincter

Sphincter of oddi (pancreatic) hypertension and recurrent pancreatitis

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