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Endoscopic sphincterotomy for adults with biliary sphincter of Oddi dysfunction
Cho Naing1, Han Ni2, Htar Htar Aung3
1Division of Tropical Health and Medicine, James Cook University, Queensland, Australia.
The Cochrane Database of Systematic Reviews
|March 22, 2024
Summary
This review found very low-certainty evidence on endoscopic sphincterotomy for sphincter of Oddi dysfunction. More high-quality trials are needed to determine its effectiveness and safety compared to other treatments.
Area of Science:
- Gastroenterology
- Digestive System Surgery
- Biliary System Disorders
Background:
- Sphincter of Oddi dysfunction (SOD) impairs bile and pancreatic juice flow due to abnormal muscular valve function.
- This condition affects the regulation of outflow from the common bile duct and pancreatic duct.
Approach:
- Systematic review of randomized clinical trials (RCTs) evaluating endoscopic sphincterotomy (ES) against placebo, sham procedures, or other treatments for biliary SOD.
- Searched Cochrane databases up to May 2023, including four RCTs with 433 participants.
Key Points:
- Evidence certainty for all outcomes was very low.
- ES showed little to no effect on treatment success, serious adverse events, quality of life, or liver function compared to sham procedures.
- Limited data exists for comparisons with balloon dilation or dual sphincterotomy, and no trials compared ES with pharmaceutical treatments.
Conclusions:
- Current evidence is insufficient to determine the benefits or harms of ES for biliary SOD.
- There is a lack of high-quality RCTs with clinically relevant outcomes to guide treatment decisions.
- Further research is needed to establish the efficacy and safety of endoscopic sphincterotomy in managing SOD.
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