Abstract
Sphincter of Oddi (SO) dysfunction is diagnosed using manometry, and patients with an abnormal SO basal pressure respond well to division of the SO. However, manometry is invasive and is associated with a low, yet significant, incidence of complications. Scintigraphy techniques have been developed with the aim of providing a noninvasive means of assessing SO motility. However, when compared with SO manometry these techniques fall short in sensitivity and specificity for diagnosing SO dysfunction. Furthermore, they do not select patients who will respond to treatment. Consequently, the quest for development of a noninvasive investigation for diagnosis of SO dysfunction continues. In the mean time, improved manometric techniques that enhance reproducibility and reduce complications have been developed.
Article PDF
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.Avoid common mistakes on your manuscript.
References and Recommended Reading
Corazziari E, Shaffer EA, Hogan WJ, et al.: Functional disorders of the biliary tract and pancreas. Gut 1999, 45(Suppl 2):1148–1154.
Geenen JE, Hogan WJ, Dodds WJ, et al.: Intraluminal pressure recording from the human sphincter of Oddi. Gastroenterology 1980, 78:317–324.
Toouli J, Roberts-Thomson IC, Kellow J, et al.: Manometry based randomised trial of endoscopic sphincterotomy for sphincter of Oddi dysfunction. Gut 2000, 46:98–102.
Scicchitana J, Saccone GTP, Baker RA, et al.: How safe is endoscopic sphincter of Oddi manometry. J Gastroenterol Hepatol 1995, 10:334–336.
Maldonado ME, Brady PG, Mamel JJ, et al.: Incidence of pancreatitis in patients undergoing sphincter of Oddi manometry (SOM). Am J Gastroenterol 1999, 94:387–390.
Zeman RK, Burrell M, Dobbins J, et al.: Postcholecystectomy syndrome: evaluation using biliary scintigraphy and endoscopic retrograde cholangiopancreatography. Radiology 1985, 156:787–792.
Shaffer EA, Hershfield NB, Logan K, et al.: Cholescintigraphic detection of function al obstruction of the sphincter of Oddi: effect of papillotomy. Gastroenterology 1986, 90:728–733.
Grimon G, Buffet C, Andre I, et al.: Biliary pain in postcholecystectomy patients without biliary obstruction: a prospective randomised study. Dig Dis Sci 1991, 36:317–320.
Fullarton GM, Allan A, Hilditch T, et al.: Quantitative 99mTc-DISIDA scanning and endoscopic biliary manometry in sphincter of Oddi dysfunction. Gut 1988, 29:1397–1340.
Farup PG, Tjara S: Sphincter of Oddi dysfunction: dynamic cholescintigraphy and endoscopic retrograde cholangiopancreatography with papillotomy in diagnosis, treatment and follow-up study. Scand J Gastroenterol 1989, 24:956–960.
Darweesh RM, Dodds WJ, Hogan WJ, et al.: Efficacy of quantitative hepatobiliary scintigraphy and fatty-meal scintigraphy for evaluating patients with suspected partial common duct obstruction. Gastroenterology 1988, 94:779–786.
Sostre S, Kalloo AN, Spiegler EI, et al.: A non-invasive test of sphincter of Oddi dysfunction in postcholecystectomy patients: the scintigraphic score. J Nucl Med 1992, 33:1216–1222.
Cicala M, Scopinaro F, Corazziari E, et al.: Quantitative cholescintigraphy in the assessment of choledochoduodenal bile flow. Gastroenterology 1991, 100:1106–1113.
Corazziari E, Cicala M, Habib FI, et al.: Hepatoduodenal bile transit in cholecystectomized subjects: relationship with sphincter of Oddi function and diagnostic value. Dig Dis Sci 1994, 39:1985–1993.
Sand JA, Turjanmaa RM, Koskinen MO, et al.: Variables affecting quantitative biliary scintigraphy in asymptomatic cholecystectomized volunteers. Hepatogastroenterology 1999, 46:130–135.
Madacsy L, Middelfart HV, Matzen P, et al.: Quantitative hepatobiliary scintigraphy and endoscopic sphincter of Oddi dysfunction: assessment of flow pressure relationship in the biliary tract. Eur J Gastroenterol Hepatol 2000, 12:777–786.
Roberts-Thomson IC, Toouli J, Blanchett W, et al.: Assessment of bile flow by radioscintigraphy in patients with biliary-type pain after cholecystectomy. Aust N Z J Med 1986, 16:788–793.
Pineau BC, Knapple WL, Spicer KM, et al.: Cholecystokinin stimulated mebrofinin (99mTc-Choletec) hepatobiliary scintigraphy in asymptomatic post-cholecystectomy individuals: assessment of specificity interobserver reliability and reproducibility. Am Gastroenterol 2001, 97:3106–3109. Important study that addresses reproducibility of scintigraphy.
Craig AG, Peter D, Saccone GTP, et al.: Scintigraphy versus manometry in patients with suggested biliary sphincter of Oddi dysfunction. Gut 2003, 52:352–357. Comparison of scintigraphy and manometry showing poor correlation.
Hogan WJ, Geenen JE: Biliary dyskinesia. Endoscopy 1988, 1:179–183.
Toouli J, Craig A: Sphincter of Oddi function and dysfunction. Can J Gastroenterol 2000, 14:411–419.
Toouli J, Roberts-Thomson IC, Dent J, et al.: Manometric disorders in patients with suspected sphincter of Oddi dysfunction. Gastroenterology 1985, 88:1243–1250.
Rosenblatt ML, Catalano MF, Alcocer E, Geenen JE: Comparison of sphincter of Oddi manometry, fatty meal sonography and hepatobiliary scintigraphy in the diagnosis of sphincter of Oddi dysfunction. Gastrointest Endosc 2001, 54:697–704.
Thomas PD, Turner JG, Dobbs BR, et al.: Use of (99m)Tc-DISIDA biliary scanning with morphine provocation for the detection of elevated sphincter of Oddi basal pressure. Gut 2000, 46:838–841.
Barish MA, Yucel EK, Ferrucci JT: Magnetic resonance cholangiopancreatography. N Engl J Med 1999, 341:258–264.
Craig AG, Omari T, Lingenfelser T, et al.: Development of a sleeve sensor for measurement of sphincter of Oddi motility. Endoscopy 2001, 33:651–657. A new manometric technique for assessing SO motility.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Toouli, J. Biliary scintigraphy versus sphincter of Oddi manometry in patients with post-cholecystectomy pain: Is it time to disregard the scan?. Curr Gastroenterol Rep 7, 154–159 (2005). https://doi.org/10.1007/s11894-005-0054-5
Issue Date:
DOI: https://doi.org/10.1007/s11894-005-0054-5