PTU-015 Medium-term outcome of endoscopic sphincterotomy in biliary manometry confirmed sphincter of oddi dysfuncton type 2

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Abstract

Introduction

There is little data in the literature regarding medium term outcome in patients with suspected sphincter of Oddi type 2 who have undergone manometry guided sphincterotomy. We have performed this procedure in our centre since 2013 and aimed to assess the medium term outcomes in our cohort.

Methods

Patients who had undergone manometry guided sphincterotomy more than three years ago for symptoms relating to sphincter of Oddi dysfunction type 2 (defined by Rome III criteria) and who had been reviewed in the short-term were assessed. Review was conducted by means of medical notes review or phone call to determine the patient’s perspective of improvement in pain and satisfaction with the treatment. Scores allocated were as follows: 1: Asymptomatic, 2: Experiencing some symptoms but significant improvement and satisfied with outcome, 3: Experiencing symptoms and dissatisfied with outcome, 4: No change in symptoms and dissatisfied with outcome.

Results

19/20 patients underwent sphincterotomy. One patient could not be followed up in the short term and was excluded from the analysis. Of the remaining patients, the mean age was 43 years and were predominantly female (n=17). 4/20 had acute pancreatitis post ERCP (3 mild, 1 moderate). There were no patients that scored a 4.

Results

In the short-term, patients had been followed-up at a mean of 17 weeks with the majority of patients finding benefit post sphincterotomy. 70% of patients reported a score of either 1 or 2 at short-term follow-up. The mean duration of medium term follow-up was 45 months. Three patients are not due for medium-term follow up for 1–2 months and three patients could not be contacted. There were no patients that remained asymptomatic. However, the majority of patients followed up were still significantly improved and happy with their outcome with a score of 2 (66.7%). Six patients are still to receive follow-up within the next two months.

Conclusions

Our results indicate that patients who have undergone manometry guided sphincterotomy for symptoms related to sphincter of Oddi dysfunction type 2 remain significantly improved in the medium-term.

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