Villavicencio Kim Jaimy, Wu George Y
Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA.
J Clin Transl Hepatol. 2022 Jun 28;10(3):515-521. doi: 10.14218/JCTH.2021.00167. Epub 2022 Jan 11.
Sphincter of Oddi dysfunction (SOD) encompasses a spectrum of clinical syndromes that are not fully understood, and various diagnostic and therapeutic methods have had varying results depending on the type of dysfunction. This review explored various mechanisms that might play a role in SOD and methods of diagnosis and management. It is important to rule out other causes of abdominal pain with laboratory testing, imaging studies, and endoscopic procedures. Medications that affect sphincter motility should be identified as well. Manometry is the gold standard for diagnosis but it is not always required. For example, patients with type I SOD may have symptomatic improvement with sphincterotomy without need for a diagnostic manometry. Hepatobiliary scintigraphy and fatty meal sonography may also have diagnostic utility. Sphincterotomy is not always effective for symptomatic improvement in type II and III SOD. Alternate therapies with calcium channel blockers and botulinum toxin have been studied and might be considered as options after discussing the risks and benefits with the patients.
Oddi括约肌功能障碍（SOD）包括一系列尚未完全了解的临床综合征，根据功能障碍的类型，各种诊断和治疗方法的效果各不相同。本综述探讨了可能在SOD中起作用的各种机制以及诊断和管理方法。通过实验室检查、影像学研究和内镜检查排除腹痛的其他原因很重要。还应确定影响括约肌运动的药物。测压是诊断的金标准，但并非总是必需的。例如，I型SOD患者在进行括约肌切开术后症状可能改善，无需进行诊断性测压。肝胆闪烁显像和脂肪餐超声检查也可能具有诊断价值。括约肌切开术对II型和III型SOD的症状改善并不总是有效。已经研究了钙通道阻滞剂和肉毒杆菌毒素等替代疗法，在与患者讨论风险和益处后可将其视为选择。
