Endoscopic therapy for sphincter of oddi dysfunction in idiopathic pancreatitis: From empiric to scientific

摘要

After excluding simple causes, the diagnostic approach to unexplained pancreatitis remains challenging, especially given the expanding number of potential etiologies as well as menu of diagnostic tests. Most of us define unexplained pancreatitis as the absence of a diagnosis after a careful history including family, social, and drug histories; physical examination; laboratory testing including calcium and triglyceride concentrations; gallbladder ultrasound; and abdominal computed tomography with contrast all fail to identify a cause. The armamentarium of additional diagnostic imaging now includes endoscopic ultrasonography and magnetic resonance cholangiopan-creatography; whether to perform 1 or both is uncertain and often center dependent. Endoscopic retrograde cho-langiopancreatography with manometry has been recommended to exclude sphincter of Oddi dysfunction (SOD).