The Role of the Flow Rate of the Pneumohydraulic System on Post–Sphincter of Oddi Manometry Pancreatitis

Meshkinpour, Hooshang; Kay, Linda; Mollot, Michael

doi:10.1097/00004836-199204000-00009

Cited by 24 publications

(12 citation statements)

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“…The authors suggested that increased PD hydrostatic pressure brought about by continuous perfusion into a closed space is the major cause of SOMP. This is in concert with another study in which the incidence of SOMP was reduced from 26% to 7% by decreasing the flow rate in the perfusion system [23]; using an electronic microtransducer instead of a perfused catheter decreased the incidence of post-manometry pancreatitis [24]. On the other hand, the Wong et al study did not find specific duct cannulation to be related to SOMP and, in the study of Maldonado et al [13], 16 of the 17 patients with SOMP had SOM in the CBD.…”

supporting

confidence: 85%

Sphincter of Oddi – still mysterious, still complicated

Rolny¹

2005

Scandinavian Journal of Gastroenterology

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supporting

confidence: 85%

Sphincter of Oddi – still mysterious, still complicated

Rolny¹

2005

Scandinavian Journal of Gastroenterology

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“…The morbidity associated with this study increases if the pancreatic duct is cannulated and pressures are recorded from the pancreatic duct segment of the SO. The incidence of pancreatitis has been shown to be reduced with lower rates of manometric catheter perfusion27 or by use of one of the manometric catheter as an aspirating port rather than as a measurement channel 15. This latter approach decreases the incidence of post-ERCP pancreatitis following pancreatic duct manometry.…”

Section: Complicationsmentioning

confidence: 99%

How to Interpret a Functional or Motility Test - Sphincter of Oddi Manometry

Cheon¹

2012

J Neurogastroenterol Motil

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To date, endoscopic manometry is the best method for evaluating the function of the sphincter. Sphincter of Oddi manometry (SOM) remains the gold standard to correctly diagnose the sphincter of Oddi dysfunction (SOD) and stratify therapy. Several dynamic abnormalities relating to the intensity, frequency, and propagation of sphincter contractions have been described. However, their clinical use generally has been abandoned in favor of basal sphincter pressure alone, because this measurement is stable over time, and has stronger interobserver reliablility, reproducibility on repeating testing, and is associated with the responsiveness to therapy. A significant elevated risk of pancreatitis was attributed to the technique. The risk of pancreatitits associated with manometric evaluation of the pancreatic sphincter is markedly reduced when manometry is performed with continous aspiration from the pancreatic duct via one of the 3 catheter lumens. This section reviews indications, conscious sedative drugs, techniques, and the appropriate interpretations of SOM.

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“…The standard method for SOM is perfused multilumen SOM using a triple-lumen device [1,20,21]; however, it is associated with a significant high risk of post-procedure pancreatitis, so it is not widely used [22][23][24]. Perfused multilumen SOM may cause volume overload of the biliopancreatic system and induce pancreatitis after the procedure [25][26][27]. Furthermore, edema of the papilla of Vater caused by repeated cannulation with a 5Fr triple-lumen catheter may also cause temporary outflow obstruction of the pancreatic juice.…”

Section: Sphincter Of Oddi Manometorymentioning

confidence: 99%

Sphincter of Oddi disorder: what is the clinical issue?

Kutsumi

Nobutani

Kakuyama

et al. 2011

Clin J Gastroenterol

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Sphincter of Oddi disorder (SOD) is a functional disorder of the sphincter of Oddi (SO) and is pathophysiologically equivalent to functional gastrointestinal disorder (FGID) of the digestive tract. SOD is important as a cause of biliary pain of unknown origin and idiopathic acute recurrent pancreatitis; however, the concept of SOD has not generally spread in the same way as FGID. SOD is diagnosed using ROME III criteria which were revised in 2006 to reduce the number of unnecessary and potentially risky procedures. Many cases of SOD still need SO manometry (SOM) which is performed during endoscopic retrograde cholangiopancreatography (ERCP). It is problematic that SOD patients, who already have a high risk of post-ERCP pancreatitis, require SOM for a definitive diagnosis. SOM is an invasive examination that is accompanied by a high risk of post-procedure pancreatitis and can be performed only at a limited number of institutions because of technical difficulties. In the treatment of SOD, the effectiveness of the drugs is uncertain, and the role of drug therapy in the management of SOD has not yet been established. In recent years, endoscopic sphincterotomy (EST) has been recognized as standard treatment for SOD; however, the effect of EST is not yet clear. The development of less invasive diagnostic techniques is desirable in the future. Furthermore, patient eligibility criteria for EST and the long-term prognosis after EST should be clarified.

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The Role of the Flow Rate of the Pneumohydraulic System on Post–Sphincter of Oddi Manometry Pancreatitis

Cited by 24 publications

References 0 publications

Sphincter of Oddi – still mysterious, still complicated

Sphincter of Oddi – still mysterious, still complicated

How to Interpret a Functional or Motility Test - Sphincter of Oddi Manometry

Sphincter of Oddi disorder: what is the clinical issue?

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