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Cotton PB, Elta GH, Carter CR, et al. Rome IV. Gallbladder and Sphincter of Oddi Disorders. Gastroenterology. 2016;doi: 10.1053/j.gastro.2016.02.033.
Cotton, P. B., Elta, G. H., Carter, C. R., Pasricha, P. J., & Corazziari, E. S. (2016). Rome IV. Gallbladder and Sphincter of Oddi Disorders. Gastroenterology, . https://doi.org/10.1053/j.gastro.2016.02.033
Cotton, P B, et al. "Rome IV. Gallbladder and Sphincter of Oddi Disorders." Gastroenterology vol. (2016). doi: https://doi.org/10.1053/j.gastro.2016.02.033
Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES. Rome IV. Gallbladder and Sphincter of Oddi Disorders. Gastroenterology. 2016 Feb 19; doi: 10.1053/j.gastro.2016.02.033. Epub 2016 Feb 19. PMID: 27144629.
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Gastroenterology. 2016 Feb 19; doi: 10.1053/j.gastro.2016.02.033. Epub 2016 Feb 19.

Rome IV. Gallbladder and Sphincter of Oddi Disorders.

Gastroenterology

P B Cotton, G H Elta, C R Carter, P J Pasricha, E S Corazziari

Affiliations

  1. Medical University of South Carolina, Charleston, SC, USA. Electronic address: [email protected].
  2. University of Michigan, Ann Arbor, MI, USA.
  3. Glasgow Royal Infirmary, Scotland.
  4. Johns Hopkins School of Medicine, Baltimore, MD, USA.
  5. Universita La Sapienza, Rome, Italy.

PMID: 27144629 DOI: 10.1053/j.gastro.2016.02.033

Abstract

The concept that motor disorders of the gallbladder, cystic duct and sphincter of Oddi can cause painful syndromes is attractive and popular, at least in the USA. However, the results of commonly performed ablative treatments (cholecystectomy and sphincterotomy) are not uniformly good. The predictive value of tests that are often used to diagnose dysfunction (dynamic gallbladder scintigraphy and sphincter manometry) is controversial. Evaluation and management of these patients is made difficult by the fluctuating symptoms and the placebo effect of invasive interventions. A recent stringent study has shown that sphincterotomy is no better than sham treatment in patients with post-cholecystectomy pain and little or no objective abnormalities on investigation, so that the old concept of sphincter of Oddi dysfunction (SOD) type III is discarded. ERCP approaches are no longer appropriate in that context. There is a pressing need for similar prospective studies to provide better guidance for clinicians dealing with these patients. We need to clarify the indications for cholecystectomy in patients with Functional Gallbladder Disorder (FGBD) and the relevance of sphincter dysfunction in patients with some evidence for biliary obstruction (previously SOD type II, now called "Functional Biliary Sphincter Disorder - FBSD") and with idiopathic acute recurrent pancreatitis.

Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Keywords: Endoscopic Retrograde Cholangio-Pancreatography (ERCP); biliary pain; cholecystectomy; idiopathic pancreatitis; post-cholecystectomy pain; sphincter manometry; sphincterotomy

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