Combined small EST and balloon dilation (ESBD) has been reported to have similar efficacy in stone extraction as EST while preserving partial function of the sphincter of Oddi
. There is a lack of consensus regarding the duration of balloon dilatation (DBD) and success or complications of procedure in all GIS dilatation therapies as in EPBD.
Sphincter of Oddi
dysfunction may manifest clinically by recurrent abdominal pain of the "biliary type" and/or episodes of acute pancreatitis, with abnormal motility of the sphincter and a significant increase in its basal pressure having been identified (75).
The cause of right hypochondrial pain can be attributed to cystic stump scarring, sphincter of oddi
dysfunction12 and psychiatric conditions13.
Although various traditional methods of biliary surgery are being widely used in clinical practice, less importance has been attached to protecting the function of the sphincter of Oddi
. Frequent reflux cholangitis after choledochojejunostomy, high postoperative recurrence of intrahepatic bile duct stones, frequent postoperative complications after hepatic pancreatoduodenectomy, and other pertinent problems have not yet been resolved.
(4) It is believed that placement of stent facilitates bile drainage into the duodenum by reducing the pressure and negating sphincter of Oddi
resistance and reduces the bile duct pressure which possibly promotes healing of the fistula.
Some of the risk factors are patient-dependent, such as young age, female gender, comorbidities, sphincter of oddi
dysfunction, history of previous AEs while others are procedure-dependent such as sphincterotomy, difficult cannulation and trainee involvement.
Prophylactic pancreas stenting followed by needle-knife fistulotomy in patients with sphincter of Oddi
dysfunction and difficult cannulation: new method to prevent post-ERCP pancreatitis.
Morphine is known to cause contractions in the sphincter of Oddi
and may cause transient increases in lipase and amylase in healthy individuals (3).
Manometric studies of the sphincter of Oddi
in patients presenting juxtapapillary diverticulum found that muscular tone, contractile activity, and total rhythmic variation are significantly less compared to patients without diverticulum .
One of those four cases had similar features to the current case: a young female with no significant comorbidities who underwent an ERCP for treatment of possible Sphincter of Oddi
Dysfunction which was complicated by Clostridium perfringens emphysematous cholecystitis requiring a cholecystectomy two days after ERCP .
Known or suspected biliary duct obstruction, or sphincter of Oddi
disease or dysfunction; a history of pancreatitis; structural diseases of the pancreas.
Periampullary diverticuli not only cause mechanical compression of the bile duct but also induce dysfunction of the sphincter of Oddi
. They are considered to lead to bile stasis and to allow reflux from the duodenum into the bile duct, which can result in an ascending infection .