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Evidence summaries

Sphincterectomy for Biliary Sphincter of Oddi Dysfunction

Sphincterectomy appears to be beneficial in patients with elevated sphincter of Oddi pressure (> 40 mmHg), but not in patients with normal basal pressure. Level of evidence: "B"

A Cochrane review [Abstract] 1 [withdrawn from publication] included 2 studies with a total of 126 subjects. The outcome measure was symptomatic response. In 49 patients studied, sphincterectomy was more effective than placebo in treating patients with an elevated pressure (OR 9.08, 95% CI 2.97 to 277.77). In 77 patients studied, sphincterectomy was no better than placebo in treating patients with a normal basal pressure (OR 1.28, 95% CI 0.52 to 3.13).

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).

References

Primary/Secondary Keywords