Abstract
Functional disorders of the biliary tree include gallbladder dyskinesia and Sphincter of Oddi dysfunction. Both present as recurrent epigastric and right upper quadrant pain reminiscent of biliary colic, in the absence of biliary stones. Gallbladder dyskinesia is defined by an ejection fraction below 35% following slow infusion of a weight based dose of CCK. The pathogenesis of pain is unclear; never-the-less, cholecystectomy is the therapy of choice. Data are mixed as to whether subnormal gallbladder emptying predicts improvement following surgery in patients with pain of suspected biliary origin. Sphincter of Oddi dysfunction is defined as pain related to fixed or dynamic obstruction of the biliary or pancreatic ducts. It is commonly characterized by whether it involves the biliary and/or the pancreatic sphincter and by the presence or absence of objective abnormalities of bile duct or pancreatic duct caliber or by abnormalities of serum liver or pancreatic enzymes during pain. Diagnosis is classically made by manometric identification of basal sphincter pressures over 40 mm Hg during endoscopic retrograde cholangiopancreatography (ERCP). SOD is treated by endoscopic sphincterotomy of the hypertensive sphincter(s). Prophylactic pancreatic stent placement is employed to reduce the risk of procedure induced pancreatitis.
| Original language | English (US) |
|---|---|
| Title of host publication | Practical Gastroenterology and Hepatology: Liver and Biliary Disease |
| Publisher | Wiley-Blackwell |
| Pages | 365-373 |
| Number of pages | 9 |
| ISBN (Print) | 9781405182751 |
| DOIs | |
| State | Published - Aug 31 2010 |
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Keywords
- Cystic duct syndrome
- Endoscopic manometry
- Gall-bladder dyskinesia
- Papillary stenosis
- Post-cholecystectomy pain
- Sphincter of Oddi dysfunction
ASJC Scopus subject areas
- Medicine(all)
Cite this
Functional Gall-Bladder and Sphincter of Oddi Disorders. / Petersen, Bret Thomas.
Practical Gastroenterology and Hepatology: Liver and Biliary Disease. Wiley-Blackwell, 2010. p. 365-373.Research output: Chapter in Book/Report/Conference proceeding › Chapter
}
TY - CHAP
T1 - Functional Gall-Bladder and Sphincter of Oddi Disorders
AU - Petersen, Bret Thomas
PY - 2010/8/31
Y1 - 2010/8/31
N2 - Functional disorders of the biliary tree include gallbladder dyskinesia and Sphincter of Oddi dysfunction. Both present as recurrent epigastric and right upper quadrant pain reminiscent of biliary colic, in the absence of biliary stones. Gallbladder dyskinesia is defined by an ejection fraction below 35% following slow infusion of a weight based dose of CCK. The pathogenesis of pain is unclear; never-the-less, cholecystectomy is the therapy of choice. Data are mixed as to whether subnormal gallbladder emptying predicts improvement following surgery in patients with pain of suspected biliary origin. Sphincter of Oddi dysfunction is defined as pain related to fixed or dynamic obstruction of the biliary or pancreatic ducts. It is commonly characterized by whether it involves the biliary and/or the pancreatic sphincter and by the presence or absence of objective abnormalities of bile duct or pancreatic duct caliber or by abnormalities of serum liver or pancreatic enzymes during pain. Diagnosis is classically made by manometric identification of basal sphincter pressures over 40 mm Hg during endoscopic retrograde cholangiopancreatography (ERCP). SOD is treated by endoscopic sphincterotomy of the hypertensive sphincter(s). Prophylactic pancreatic stent placement is employed to reduce the risk of procedure induced pancreatitis.
AB - Functional disorders of the biliary tree include gallbladder dyskinesia and Sphincter of Oddi dysfunction. Both present as recurrent epigastric and right upper quadrant pain reminiscent of biliary colic, in the absence of biliary stones. Gallbladder dyskinesia is defined by an ejection fraction below 35% following slow infusion of a weight based dose of CCK. The pathogenesis of pain is unclear; never-the-less, cholecystectomy is the therapy of choice. Data are mixed as to whether subnormal gallbladder emptying predicts improvement following surgery in patients with pain of suspected biliary origin. Sphincter of Oddi dysfunction is defined as pain related to fixed or dynamic obstruction of the biliary or pancreatic ducts. It is commonly characterized by whether it involves the biliary and/or the pancreatic sphincter and by the presence or absence of objective abnormalities of bile duct or pancreatic duct caliber or by abnormalities of serum liver or pancreatic enzymes during pain. Diagnosis is classically made by manometric identification of basal sphincter pressures over 40 mm Hg during endoscopic retrograde cholangiopancreatography (ERCP). SOD is treated by endoscopic sphincterotomy of the hypertensive sphincter(s). Prophylactic pancreatic stent placement is employed to reduce the risk of procedure induced pancreatitis.
KW - Cystic duct syndrome
KW - Endoscopic manometry
KW - Gall-bladder dyskinesia
KW - Papillary stenosis
KW - Post-cholecystectomy pain
KW - Sphincter of Oddi dysfunction
UR - http://www.scopus.com/inward/record.url?scp=84886068323&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84886068323&partnerID=8YFLogxK
U2 - 10.1002/9781444325249.ch34
DO - 10.1002/9781444325249.ch34
M3 - Chapter
AN - SCOPUS:84886068323
SN - 9781405182751
SP - 365
EP - 373
BT - Practical Gastroenterology and Hepatology: Liver and Biliary Disease
PB - Wiley-Blackwell
ER -