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Attribution of unexplained biliary- or pancreatic-type pain to sphincter of Oddi dysfunction (SOD) remains controversial. Now, results are available from the first randomized trial to assess diagnostic utility of sphincter of Oddi manometry (SOM) and efficacy of endoscopic sphincterotomy in patients with suspected SOD after cholecystectomy.
A double-blind, sham-controlled, randomized trial was conducted at seven U.S. tertiary centers and included 214 patients (>90% white and female) with suspected SOD (primarily type III). After undergoing SOM, investigators randomized 141 patients to undergo sphincterotomy and 73 to undergo sham sphincterotomy. All patients received temporary pancreatic duct stents, but rectal indomethacin was not utilized.…