Sphincter of Oddi dysfunction (SOD) is a spasm of the sphincter muscle that causes a backup of bile from the liver and enzymes from the pancreas. In severe cases, the experts at MUSC can cut the sphincter to facilitate drainage of the pancreatic duct and relieve pressure. Endoscopic sphincterotomy (ES) is the current standard of treatment for SOD, but is best performed at specialized centers. MUSC is well-known for its expertise in treating SOD and is currently involved in a National Institutes of Health study (EPISOD) designed to improve treatment of SOD patients. ES does carry a significant risk for post-procedure pancreatitis of 5-20 percent. Also, restenosis, where the muscle scars back down, is reported in 25-33 percent of patients, and requires another procedure.
If the pressure is especially high, the sphincter may be cut during the ERCP procedure (sphincterectomy) to provide relief. However, sphincterectomy also can cause bleeding, perforation, scarring and potentially pancreatitis. Surgery may be considered as an alternative way to open up the sphincter of Oddi (sphincteroplasty) and may be one of the only options if endoscopic sphincterectomy does not work in the long or short term.
SOD should be approached and managed with considerable care. Patients can expect better results from a specialty center such as MUSC, where investigators from MUSC currently are involved in a National Institutes of Health study (EPISOD) designed to improve treatment of SOD patients.