Function and dysfunction of the sphincter of Oddi.

Area of Science:

• Gastroenterology
• Digestive Physiology

Background:

• The sphincter of Oddi (SO) regulates bile and pancreatic juice flow into the duodenum.
• Understanding SO function is crucial for diagnosing and treating biliary and pancreatic disorders.

Purpose of the Study:

• To provide a comprehensive review of sphincter of Oddi (SO) function, control mechanisms, and diagnostic methods.
• To detail the pathophysiology, diagnosis, and treatment of SO dysfunction, including stenosis and dyskinesia.

Main Methods:

• Review of existing literature on SO physiology and pathophysiology.
• Explanation of diagnostic tests: Nardi test, perfusion manometry, microtransducer manometry, and cholescintigraphy.
• Discussion of treatment modalities for SO dysfunction.

Main Results:

• Normal SO motility is influenced by neural and hormonal factors and coordinated with gallbladder and duodenal activity.
• Various diagnostic tests exist to evaluate SO function, each with specific applications.
• Sphincter of Oddi manometry and endoscopic sphincterotomy are effective treatments for severe SO dysfunction.

Conclusions:

• SO dysfunction, encompassing stenosis and dyskinesia, requires careful diagnosis and management.
• Invasive procedures like manometry and sphincterotomy are reserved for patients with severe symptoms justifying their use.