Medical treatment for sphincter of oddi dysfunction：Can it replace endoscopic sphincterotomy

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 w...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2012-04, Vol.18 (14), p.1610-1615
Main Authors: Vitton, Véronique, Ezzedine, Salah, Gonzalez, Jean-Michel, Gasmi, Mohamed, Grimaud, Jean-Charles, Barthet, Marc
Format: Article
Language:English
Subjects:
Adult
Brief
Female
Follow-Up Studies
Gastrointestinal Agents - therapeutic use
Humans
Male
Middle Aged
Nitrates - therapeutic use
Prospective Studies
Sphincter of Oddi Dysfunction - drug therapy
Sphincter of Oddi Dysfunction - surgery
Sphincterotomy, Endoscopic
Treatment Outcome
Trimebutine - therapeutic use
保守治疗
内镜
功能障碍
平均周期
平均年龄
括约肌
药物治疗
超氧化物歧化酶
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Summary: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.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v18.i14.1610