[Management of Oddi sphincter dyskinesis. Results of drug therapy and sphincterotomy]. / Az Oddi-sphincter dyskinesis kezelése. A gyógyszeres terápia és a sphincterotomia eredményei.

ABSTRACT

UNLABELLED In a retrospective evaluation, the outcome of the long term treatment of the sphincter of Oddi dyskinesia (OD, type III. dysfunction) has been analysed. PATIENTS AND METHOD: Therapeutic results of 64 cholecystectomised patients with OD were evaluated by means of regular follow-up and questionnaire filled in either by the patients or their practitioners. RESULTS: Conservative treatment (nitroglycerin, calcium channel blocker or both) resulted in symptom-free condition or improvement with 53% of the patients (37/64). Out of 27 patients whose condition did not improve by combined drug therapy, in 20 cases endoscopic sphincterotomy (EST) and in 1 case transduodenal sphincterotomy were performed. Having followed sphincterotomy, out of 21 patients only 9 became symptom-free and 5 improved. CONCLUSIONS: Therapeutic benefit of sphincter relaxants fail in nearly half of the cases with OD, and even sphincterotomy can lead to symptomless condition only in a portion of OD. Regarding the high incidence of complications following EST in OD, it can only be recommended after failure of the conservative therapy in correctly diagnosed cases. The results emphasise a need for a prospective randomised controlled clinical study to seek for the optimal therapeutic regimen.