Brief Article
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World J Gastroenterol. Apr 14, 2012; 18(14): 1610-1615
Published online Apr 14, 2012. doi: 10.3748/wjg.v18.i14.1610
Medical treatment for sphincter of oddi dysfunction: Can it replace endoscopic sphincterotomy?
Véronique Vitton, Salah Ezzedine, Jean-Michel Gonzalez, Mohamed Gasmi, Jean-Charles Grimaud, Marc Barthet
Véronique Vitton, Salah Ezzedine, Jean-Michel Gonzalez, Mohamed Gasmi, Jean-Charles Grimaud, Marc Barthet, Department of Gastroenterology, Hôpital Nord, Chemin des Bourrely, 13915 Marseille cedex 20, France
Author contributions: Vitton V and Barthet M contributed to study concept and design, acquisition and interpretation of the data, drafting of the manuscript and critical and final revisions of the manuscript; Ezzedine S and Gasmi M contributed to acquisition and interpretation of the data and critical revision of the manuscript; Gonzalez JM contributed to acquisition and interpretation of the data and drafting of the manuscript; Grimaud JC contributed to study concept and design and critical revision of the manuscript.
Correspondence to: Veronique Vitton, MD, PhD, Department of Gastroenterology, Hôpital Nord, Chemin des Bourrely, 13915 Marseille cedex 20, France. vittonv@yahoo.com
Telephone: +33-4-91965598 Fax: +33-4-91965550
Received: April 18, 2011
Revised: June 16, 2011
Accepted: February 27, 2012
Published online: April 14, 2012
Abstract

AIM: To report the results of a medical management of sphincter of oddi dysfunction (SOD) after an intermediate follow-up period.

METHODS: A total of 59 patients with SOD (2 men and 57 women, mean age 51 years old) were included in this prospective study. After medical treatment for one year, the patients were clinically re-evaluated after an average period of 30 mo.

RESULTS: The distribution of the patients according to the Milwaukee’s classification was the following: 11 patients were type 1, 34 were type 2 and 14 were type 3. Fourteen patients underwent an endoscopic sphincterotomy (ES) after one year of medical treatment. The median intermediate follow-up period was 29.8 ± 3 mo (3-72 mo). The initial effectiveness of the medical treatment was complete, partial and poor among 50.8%, 13.5% and 35%, respectively, of the patients. At the end of the follow-up period, 37 patients (62.7%) showed more than 50% improvement. The rate of improvement in patients who required ES was not significantly different compared with the patients treated conservatively (64.2% vs 62.2%, respectively).

CONCLUSION: Our study confirms that conservative medical treatment could be an alternative to endoscopic sphincterotomy because, after an intermediate follow-up period, the two treatments show the same success rates.

Keywords: Sphincter of oddi dysfunction; Cholecystectomy; Endoscopic sphincterotomy; Biliary scintigraphy