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Sphincter of Oddi dysfunction

Key sources
The following summarized guidelines for the evaluation and management of sphincter of Oddi dysfunction are prepared by our editorial team based on guidelines from the European Society of Gastrointestinal Endoscopy (ESGE 2016), the American Society for Gastrointestinal Endoscopy (ASGE 2015), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES 2010).
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Guidelines

1.Diagnostic procedures

Endoscopic retrograde cholangiopancreatography: do not obtain diagnostic ERCP for the evaluation of pancreaticobiliary-type pain in the absence of objective abnormalities on other pancreaticobiliary imaging or laboratory studies.
D
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2.Surgical interventions

Sphincterotomy
As per ESGE 2016 guidelines:
Reserve biliary sphincterotomy for patients undergoing pancreatic sphincterotomy in the presence of evidence of coexisting bile duct obstruction or biliary sphincter of Oddi dysfunction.
B
Use mixed current rather than pure cut current alone for sphincterotomy, as there is a decreased risk of mild bleeding with the former.
B

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