At Johns Hopkins, our comprehensive approach means that your doctors have the complete picture of you and your condition before beginning treatment. The goal of treatment for sphincter of Oddi dysfunction reduces pressure on the sphincter, thereby reducing your pain. This will improve drainage of the biliary and pancreatic juices into the small intestine.
Treatment options include:
Treating sphincter of Oddi dysfunction with medication is the preferred method because it is noninvasive and avoids the possible severe complications of a sphincterotomy (cutting the sphincter muscle). The sphincter of Oddi is made of smooth muscle, and medications that relax smooth muscle may be an effective treatment option. Other medications aim to reduce sphincter pressure and reduce symptoms.
Medication has some drawbacks, including side effects. Also, certain types of sphincter of Oddi dysfunction may not respond to medication.
A common procedure performed for sphincter of Oddi dysfunction is a transduodenal sphincteroplasty. A sphincteroplasty is a reconstruction of your sphincter muscle. In this case, your surgeon accesses your sphincter of Oddi through your duodenum (small intestine).
Surgical technique for transduodenal sphincteroplasty with transampullary septoplasty. (Click to Enlarge)
Surgical technique for transduodenal sphincteroplasty. (Click to Enlarge)
The standard of therapy for sphincter of Oddi dysfunction is endoscopic sphincterotomy. Your doctor uses an endoscope to locate the sphincter of Oddi and then cuts the muscle to prevent future spasms. After endoscopic sphincterotomy, there is a risk of developing pancreatitis, so a short-term stent is placed to keep the sphincter open.
See illustration: Technique for endoscopic sphincterotomy.