Invited Commentary

Commentary on “Risk Stratification for the Development of Post-ERCP Pancreatitis by Sphincter of Oddi Dysfunction Classification”

Authors: Jayapal Ramesh, MD, FRCP(UK), Klaus Mönkemüller, MD, PhD, C. Mel Wilcox, MD, MPSH

Abstract

Sphincter of Oddi dysfunction (SOD) is a collection of disparate pain syndromes caused by functional, structural, or combined abnormality of the sphincter of Oddi. The clinical manifestations of SOD range from recurrent acute pancreatitis and abnormal liver function tests to isolated abdominal pain. Although there is considerable disagreement regarding the definition of this disorder, the modified Milwaukee classification1 groups the disorder into three types based on clinical symptomatology and laboratory and radiological investigations. Sphincter of Oddi manometry (SOM) is the gold standard investigation for diagnosing the disorder because other noninvasive investigations lack sufficient sensitivity and specificity for primary use; however, the procedure is invasive and carries significant risk of postprocedure pancreatitis.

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References

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