Background and Study Aims: Endoscopic microtransducer manometry of the sphincter of Oddi has been shown to be
a reliable alternative to perfusion manometry for evaluating sphincter of Oddi motor
function. It avoids volume loading of the biliopancreatic system, and may therefore
be associated with a lower risk of inducing postmanometry pancreatitis.Patients and Methods: During a 2-year period, microtransducer manometry of the sphincter of Oddi was carried
out in 215 patients (median age 42 years; 155 women; biliary study in 152 cases, additional
pancreatic evaluation in 63 cases). Sphincter of Oddi manometry was conducted as the
sole procedure in all patients. The frequency of pancreatitis was assessed prospectively
and graded according to established guidelines. A total of 130 consecutive patients
(median age 37 years, 92 women; 30 with biliary type II, 58 with type III, 34 with
pancreatic type I, and eight with type II) were then randomly assigned to undergo
microtransducer or perfusion manometry of the sphincter of Oddi in a standardized
fashion.
Results: During the initial 2-year period, nine cases of pancreatitis (a pancreatitis frequency
of 4.2 %) were observed after microtransducer manometry, and most were of mild degree
(six mild, two moderate, and one severe). No deaths occurred, and no surgical procedures
were required. In the randomized part of the study, the demographic and clinical characteristics
of the patients in both groups, as well as the technical aspects of the procedures
performed, were well matched. The frequency of pancreatitis after microtransducer
manometry was 3.1 %, compared with 13.8 % after perfusion manometry (P < 0.05). Pancreatitis occurred in two patients after microtransducer manometry, and
was mild in both cases. After perfusion manometry, mild pancreatitis occurred in six
patients and moderate pancreatitis in three.
Conclusion: Endoscopic microtransducer manometry of the sphincter of Oddi is associated with
a lower risk for postmanometry pancreatitis than standard perfusion manometry.
References
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