Endoscopic Diagnosis And Therapy For Biliary Type Of Sphincter Of Oddi Dysfunction After Cholecystectomy

The prevalence of biliary pain after cholecystectomy is 5%~10%. Now sphincter of Oddi dysfunction(SOD) is thought as one of the important causes for the post-cholecystectomy syndrome(PCS).Objective: To investigate the diagnosis and treatment value of endoscopy for biliary type of SOD after cholecystectomy. Methods: According to the diagnostic criteria for SOD (Romeâ…¡) ,28 cases were enrolled. The patients whose diagnostic features of endoscopy and X-ray appearances with ERCP consistented with the above- mentioned criteria, EST or EPBD was performed.Results: ERCP showed a dilated common bile duct (>1.2cm) in all cases. NO stones and other structural causes were founded. Beak form narrow and gradual narrow in inferior bile duct can be seen in 19 cases. EST was performed in 25 cases, and EPBD in 3 cases. Complete efficacy on the biliary pain of the endoscopic treatment was observed in 22 patients (78.57 %). Symptoms alleviated partly after the treatment in 4 cases (14.29 %), without alleviation in 2cases (7.14 %) , the totally effective rate is 92.86 %. The symptom of fever and jaundice completely disappeared. Elevated liver enzymes reverted to normal. Acute pancreatitis was found in1 case after EST. The patient was cured through abrosia and antiinflammatory. No other severe complication happened. Conclusion: ERCP, EST and EPBD are mini-invasive, effective, safe diagnosis and treatment methods for biliary type of sphincter of Oddi dysfunction after cholecystectomy.