THE INCIDENCE OF POST-SPHINCTEROTOMY STENOSIS IN-GROUP II PATIENTS WITH SPHINCTER OF ODDI DYSFUNCTION

Patients with group II sphincter of Oddi dysfunction documented by ele vated sphincter of Oddi pressure improve after endoscopic sphincteroto my. A large group II population was studied to determine the incidence of post-endoscopic sphincterotomy stenosis. Eighty-five patients (82 women and 3 men), ages 21 to 88 years (mean, 50 years), fulfilled the clinical criteria for group II sphincter of Oddi dysfunction; each had an elevated basal sphincter of Oddi pressure (greater-than-or-equal-t o 40 mm Hg), and received endoscopic sphincterotomy. These patients we re observed for a mean of 7 +/- 3 years. Four patients re-presented wi th clinical findings suggestive of recurrent sphincter of Oddi dysfunc tion; all were found to have a basal sphincter of Oddi pressure greate r than or equal to 40 mm Hg. Symptoms re-developed within 4 months aft er endoscopic sphincterotomy (mean, 3.3 months). Endoscopic sphinctero tomy was repeated in all four patients with one endoscopically treated complication. On 25-month mean follow-up, none of the patients had fu rther signs or symptoms of papillary stenosis. Endoscopic sphincteroto my in patients with group II sphincter of Oddi dysfunction is associat ed with a low incidence of restenosis (4.7%). Repeat endoscopic sphinc terotomy was found to be effective management in patients with papilla ry restenosis.