When biliary-type pain is accompanied by objective biliary abnormalities on blood tests or imaging, sphincter of Oddi dyskinesia enters a specific clinical subset where a defined first-line intervention is supported by high-quality evidence.
Patients presenting with biliary pain and 1 or 2 of the following objective criteria:
The evidence-based approach for this presentation centres on an endoscopic procedure targeting the biliary sphincter, carried out during ERCP. The full structured protocol — including the complete procedural pathway and patient selection details — is available via the link below.
Treatment goal: long-term relief of biliary-type pain.
DOI: 10.3390/jcm12144802
Biliary pain and 1 or 2 out of the 3 above criteria.
Endoscopic sphincterotomy is the most commonly used non-pharmacologic treatment for SOD for patients with type 1 and 2 SOD.
The management of SOD most often involves non-pharmacologic treatment, and high-level evidence supports sphincterotomy in type 1 and 2 SOD.
Two randomized controlled trials [2,17], including a sphincterotomy group and a control group receiving sham intervention, showed that patients with abnormally elevated basal pressure showed over 90% long-term relief in symptoms related to biliary-type pain when undergoing sphincterotomy of the biliary SO.
View source ↗