ABSTRACT
Sphincter of Oddi dysfunction (SOD) refers to a series of clinical syndromes that occurs because of structural or functional disorders involving the biliary and/or pancreatic sphincters.It remains controversial whether endoscopic sphincter manometry (SOM) or sphincterotomy is needed in patients with type Ⅲ SOD.An important problem is that ERCP (with or without SOM) carries significant risks, especially the post-ERCP pancreatitis.The EPISOD trial has updated our knowledge on type Ⅲ SOD.The latest Rome Ⅳ consensus suggested that the classification term type Ⅲ biliary SOD should be abandoned and a new classification of biliary SOD was proposed;also, manometry and sphincterotomy were not recommended for patients with this type of SOD.The goal of this paper is to review recent literatures and elucidate the selected important questions regarding type Ⅲ SOD.