Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
J Neurogastroenterol Motil. 2012 Apr;18(2):211-7. doi: 10.5056/jnm.2012.18.2.211. Epub 2012 Apr 9.
To date, endoscopic manometry is the best method for evaluating the function of the sphincter. Sphincter of Oddi manometry (SOM) remains the gold standard to correctly diagnose the sphincter of Oddi dysfunction (SOD) and stratify therapy. Several dynamic abnormalities relating to the intensity, frequency, and propagation of sphincter contractions have been described. However, their clinical use generally has been abandoned in favor of basal sphincter pressure alone, because this measurement is stable over time, and has stronger interobserver reliablility, reproducibility on repeating testing, and is associated with the responsiveness to therapy. A significant elevated risk of pancreatitis was attributed to the technique. The risk of pancreatitits associated with manometric evaluation of the pancreatic sphincter is markedly reduced when manometry is performed with continous aspiration from the pancreatic duct via one of the 3 catheter lumens. This section reviews indications, conscious sedative drugs, techniques, and the appropriate interpretations of SOM.
迄今为止，内镜测压法是评估括约肌功能的最佳方法。胆道口括约肌测压法（SOM）仍然是正确诊断胆道口括约肌功能障碍（SOD）和分层治疗的金标准。已经描述了几种与括约肌收缩的强度、频率和传播有关的动力学异常。然而，由于这种测量方法在时间上是稳定的，并且具有更强的观察者间可靠性、重复测试的可重复性，并且与治疗反应性相关，因此它们的临床应用通常已经被放弃，而仅使用基础括约肌压力。该技术与胰腺炎的高风险显著相关。当通过三个导管腔之一从胰管持续抽吸进行测压时，胆道口括约肌测压评估相关的胰腺炎风险显著降低。本节回顾了 SOM 的适应证、清醒镇静药物、技术和适当的解释。
