The Clinical Characteristics of 16 Patients with Sphincter of Oddi Dyskinesia / 대한소화기내시경학회지

We evaluated the clinical characteristics of patients with SO dyskinesia(n=16) who were confirmed by ERCP manometry during past 5 years. They were 14 male and 2 female and mean age was 52-year-old(range, 32-75). According to the criteria suggested by Hogan and Geenen, 13 patients were classified into biliary type and 3 patients into pancreatic type. Among the patients with biliary type(n=13), 12 patients fulfilled the criteria for group II dysfunction of SO and 1 patient for group III. Among the patients with pancreatic type(n=3), all fulfilled the criteria for group II. The manometric abnormalities were increased basal pressure(n=4), tachyoddia(n=7), increased retrograde propagation(n=3), tachyoddia and increased retrograde propagation(n=l), and tachyoddia and increased basal pressure(n=l). As treatment, 12 patients received conventional endoscopic sphincterotomy and 3 patients received endoscopic pancreatic sphincterotomy in addition to conventional endoscopic sphincterotomy. Satisfactory results (complete absence or marked reduction of pain) were obtained in 13(87%) out of 15 patients by endoscopic treatment. In conclusion, SO dyskinesia is not so common disease and the detection of patients with SO dyskinesia may increase by frequent application of ERCP manometry.

The Frequency of Phasic Wave Confraction is Variable during Long - Term Sphincter of Oddi (SO) Manometry / 대한소화기내시경학회지

Objectives: The sphincter of Oddi(SO) manometry via transpapillary route is performed usually for a period of several minutes. To investigate whether there is a considerable variation in the manometric measurements of SO over a longer period of time, we have performed long-term manometry of SO via transpapillary(n=5) as well as percutaneous(n=7) route. Methods: Transpapillary manometry of SO was carried out by conventional low- compliant continuously perfused techni~que. The location of the manometric catheter was maintained at the same level by observing the video monitor. SO manometry and the duodenal migrating motor complex(MMC) was simuitaneously measured with specially designed catheter via pereutaneous route. Results: The mean recording time was 41 minutes(range 11-72 minutes). The frequency of phasic contractions of SO varied from 0 to 12/min. Throughout the whole recording period, high-frequency contractians(over 8/min) were noted in 14.9 % of the time. In the eases of percutaneous transductal SO manometry, the periods of high-frequency contractions coincided with the phase III of duodenal MMC. The interval between the first high-frequency contractions and the second was 47 minutes. The mean duration of high-frequency contractions was 6 minutes and 4~2 seconds. There as no significant change in the amplitude, basal pressure and contraction sequence among the various periods of frequencies. Conclusions: Long-term continuous recording of SO manometry via transpapillary and percutaneous route showed that the contraction frequency of SO was not constant and tachyoddia appearde periodically. In the interpretation of tachyoddia, it is necessary to consider the period of phase III of the duodenal MMC.