Biliary sphincter of Oddi dysfunction type I versus occult biliary microlithiasis in post-cholecystectomy patients: are they both part of the same clinical entity?

Abstract

We speculate that biliary sphincter of Oddi dysfunction type I and symptomatic migrating biliary microlithiasis may be part of the same disease process. A retrospective analysis of prospectively collected data was carried out using procedure and diagnosis codes during the period of 1997-2006. Seventeen patients (age 51 +/- 17; 94% women) with prior cholecystectomy, right upper quadrant/epigastric abdominal pain, elevated liver enzymes, dilated biliary ducts seen on ultrasound/CT scan were identified. The patients underwent ERCP with biliary endoscopic sphincterotomy. Nine (53%) had biliary microlithiasis and eight (47%) had biliary sphincter of Oddi dysfunction type I. They were followed for 2-108 weeks (median 9 weeks). 6/8 (75%) in biliary sphincter of Oddi dysfunction type I and 6/9 (67%) in biliary microlithiasis group had resolution of abdominal pain (P = 1.00). We conclude that the clinical improvement with biliary sphincterotomy for biliary sphincter of Oddi dysfunction type I versus occult biliary microlithiasis was not significantly different.

• Authors: Farshad Elmi, William B Silverman
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 55 Issue 3 Pg. 842-6 (Mar 2010) ISSN: 1573-2568 [Electronic] United States
• PMID: 19337835 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Cholangiopancreatography, Endoscopic Retrograde
• Cholecystectomy
• Cholelithiasis (diagnosis)
• Female
• Humans
• Male
• Middle Aged
• Postoperative Complications
• Retrospective Studies
• Sphincter of Oddi Dysfunction (diagnosis)