clinendoКлиническая эндоскопияFilin’s Clinical endoscopy2415-7813"Global Media technology" Ltdclinendo-334Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESЭндоскопия при дисфункции сфинктера ОддиКороткевичА. Г.alkorot@mail.ruЕфремоваО. Р.noemail@neicon.ruИнститут усовершенствования врачей, МГКБ №29Russian Federation20080912202542132Copyright © Короткевич А.Г., Ефремова О.Р., 20252025Короткевич А.Г., Ефремова О.Р.Короткевич А.Г., Ефремова О.Р.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://clinendo.elpub.ru/jour/article/view/334

Проблема диагностики и лечения дисфункции сфинктера Одди остается актуальной. В статье анализируется собственный опыт и литературные данные по эндоскопической диагностике ДСО. Сформулированы общие представления и лечебно-диагностические подходы при подозрении на ДСО. Проведен анализ 927 медицинских карт с выявленными при эндоскопии изменениями сфинктера Одди, оценены критерии визуальной диагностики ДСО. ЭРПХГ выполнена у 31 больного с дисфункцией сфинктера Одди. Отдаленные результаты показали возможность эндоскопической диагностики ДСО и высокую лечебную эффективность ЭПСТ.

ReferencesБелоусов А.С., Водолагин В.Д., Жаков В.П. Диагностика, дифференциальная диагностика и лечение болезней органов пищеварения. - М.: Медицина, 2002. - 424 с.Белоусов А.С., Водолагин В.Д., Жаков В.П. Диагностика, дифференциальная диагностика и лечение болезней органов пищеварения. - М.: Медицина, 2002. - 424 с.Вехновская И.З. Качество жизни больных дисфункцией желчного пузыря, сфинктера Одди и хроническим бескаменным холециститом : Автореф..к.м.н, Уфа, 2006 - 24 с.Вехновская И.З. Качество жизни больных дисфункцией желчного пузыря, сфинктера Одди и хроническим бескаменным холециститом : Автореф..к.м.н, Уфа, 2006 - 24 с.Ильченко А.А. Дисфункциональные расстройства билиарного TpaKra//Consilium Мес1юит/приложение.-2002.-№1.-С.20-23.Ильченко А.А. Дисфункциональные расстройства билиарного TpaKra//Consilium Мес1юит/приложение.-2002.-№1.-С.20-23.Калинин А.В. Дисфункции сфинктера Одди и их лечение. Русский медицинский журнал (электронная версия), 2005 http://www.rmj.ru/Калинин А.В. Дисфункции сфинктера Одди и их лечение. Русский медицинский журнал (электронная версия), 2005 http://www.rmj.ru/Маев И.В., Самсонов А, А., Салова Л.М. и др. Диагностика и лечение заболеваний желчевыводящих путей: Учебное пособие. - М.:ГОУ ВУНМЦ М3 РФ,- 2003.-96 с.Маев И.В., Самсонов А, А., Салова Л.М. и др. Диагностика и лечение заболеваний желчевыводящих путей: Учебное пособие. - М.:ГОУ ВУНМЦ М3 РФ,- 2003.-96 с.Медицина. Медицинские справочники ГЛАВА 34. НАРУШЕНИЕ ФУНКЦИИ СФИНКТЕРА ОДДИ http://www.grandex.ru/company.htmlМедицина. Медицинские справочники ГЛАВА 34. НАРУШЕНИЕ ФУНКЦИИ СФИНКТЕРА ОДДИ http://www.grandex.ru/company.htmlНадинская М.Ю. Дисфункциональные расстройства билиарного тракта Consilium Medicum Том 02/N 3/2002 /media/refer/02_03/shtml :: Wednesday, 09-0ct-2002 20:46:16 MSDНадинская М.Ю. Дисфункциональные расстройства билиарного тракта Consilium Medicum Том 02/N 3/2002 /media/refer/02_03/shtml :: Wednesday, 09-0ct-2002 20:46:16 MSDПальгова Л.К. Дисфункциональные расстройства билиарного тракта. Патогенез. Критерии диагностики и принципы коррекции, (клиническая лекция для врачей) Алматы 2004, 38 с.Пальгова Л.К. Дисфункциональные расстройства билиарного тракта. Патогенез. Критерии диагностики и принципы коррекции, (клиническая лекция для врачей) Алматы 2004, 38 с.Постхолецистэктомический синдром (дисфункция сфинктера Г)пли)- современные принципы диагностики и лечения (методические рекомендации) Киев - 2004Постхолецистэктомический синдром (дисфункция сфинктера Г)пли)- современные принципы диагностики и лечения (методические рекомендации) Киев - 2004Функциональные заболевания желчевыводящих путей: классификация, клиническая картина и терапия. Гастросайт. Для врачей. Избранные презентации http://www.gastrosite.ru/doctors/presentations/article.asp?id= 1430 ->Функциональные заболевания желчевыводящих путей: классификация, клиническая картина и терапия. Гастросайт. Для врачей. Избранные презентации http://www.gastrosite.ru/doctors/presentations/article.asp?id= 1430 ->Arguedas M.R., Linder J.D., Wilcox C.M. Suspected sphincter of Oddi dysfunction type II: empirical biliary sphincterotomy or manometry-guided therapy? Endoscopy 2004; 36:174-8.Arguedas M.R., Linder J.D., Wilcox C.M. Suspected sphincter of Oddi dysfunction type II: empirical biliary sphincterotomy or manometry-guided therapy? Endoscopy 2004; 36:174-8.Aronson N. Flamm C.R., Bohn R.L. et al. Evidence-based assessment: patient, procedure, or operator factors associated with ERCP complications. Gastrointest Endosc Vol. 56(6) (SUPPL): S294 -S302Aronson N. Flamm C.R., Bohn R.L. et al. Evidence-based assessment: patient, procedure, or operator factors associated with ERCP complications. Gastrointest Endosc Vol. 56(6) (SUPPL): S294 -S302Bistritz L., Bain V.G. Sphincter of Oddi dysfunction: managing the patient with chronic biliary pain. World J Gastroenterol 2006; 12:3793-802.Bistritz L., Bain V.G. Sphincter of Oddi dysfunction: managing the patient with chronic biliary pain. World J Gastroenterol 2006; 12:3793-802.Botoman V.A, Kozarek R.A, Novell L.A et al. Long-term outcome after endoscopic sphincterotomy in patients with biliary colic and suspected sphincter of Oddi dysfunction Gastroint Endoscopy 1994 March Volume 40, Issue 2, Pages 165-170Botoman V.A, Kozarek R.A, Novell L.A et al. Long-term outcome after endoscopic sphincterotomy in patients with biliary colic and suspected sphincter of Oddi dysfunction Gastroint Endoscopy 1994 March Volume 40, Issue 2, Pages 165-170Catalano M. F., Ahmed U., Chauhan Sh.S. etal. Sphincter of Oddi Dysfunction in Patients with Post Cholecystectomy Syndrome (PCS) and Acute Recurrent Pancreatitis (ARP): Efficacy of Repeat SOM After Recurrence of Symptoms. Gastrointest Endosc 2005 Vol. 61 (5): AB188Catalano M. F., Ahmed U., Chauhan Sh.S. etal. Sphincter of Oddi Dysfunction in Patients with Post Cholecystectomy Syndrome (PCS) and Acute Recurrent Pancreatitis (ARP): Efficacy of Repeat SOM After Recurrence of Symptoms. Gastrointest Endosc 2005 Vol. 61 (5): AB188Catalano M.F., Rosenblatt M.L., Geenen J.E. et al. Diagnosis of sphincter of oddi dysfunction (SOD): comparison of sphincter of oddi manometry (SOM), fatty meal sonography (FMS), and hepatobiliary scintigraphy (HBS). Gastroint Endoscopy 2001 Vol. 53(5):AB71Catalano M.F., Rosenblatt M.L., Geenen J.E. et al. Diagnosis of sphincter of oddi dysfunction (SOD): comparison of sphincter of oddi manometry (SOM), fatty meal sonography (FMS), and hepatobiliary scintigraphy (HBS). Gastroint Endoscopy 2001 Vol. 53(5):AB71Cicala М., Habib F.I., Vavassori P. et al. Outcome of endoscopic sphincterotomy in post cholecystectomy patients with sphincter of Oddi dysfunction as predicted by manometry and quantitative choledochoscintigraphy. Gut 2002; 50:665-8.Cicala М., Habib F.I., Vavassori P. et al. Outcome of endoscopic sphincterotomy in post cholecystectomy patients with sphincter of Oddi dysfunction as predicted by manometry and quantitative choledochoscintigraphy. Gut 2002; 50:665-8.Cohen S., Bacon B.R., Berlin J.A etal. National Institutes of Health State-of-the-Science Conference Statement: ERCP for diagnosis and therapy, January 14-16, 2002 Gastrointestinal Endoscopy 2002 Vol. 56 (б))"803-809Cohen S., Bacon B.R., Berlin J.A etal. National Institutes of Health State-of-the-Science Conference Statement: ERCP for diagnosis and therapy, January 14-16, 2002 Gastrointestinal Endoscopy 2002 Vol. 56 (б))"803-809Corazziari E. Sphincter of Oddi dysfunction. Dig Liver Dis 2003; 35 Suppl 3:S26-9.Corazziari E. Sphincter of Oddi dysfunction. Dig Liver Dis 2003; 35 Suppl 3:S26-9.Freeman ML., Gill М., Overby C., Cen Y.Y. Predictors of outcomes after biliary and pancreatic sphincterotomy for sphincter of oddi dysfunction. J Clin Gastroenterol 2007; 41:94-102.Freeman ML., Gill М., Overby C., Cen Y.Y. Predictors of outcomes after biliary and pancreatic sphincterotomy for sphincter of oddi dysfunction. J Clin Gastroenterol 2007; 41:94-102.Fogel E.L., Eversman D., Jamidar P. et al. Sphincter of Oddi dysfunction: pancreaticobiliary sphincterotomy with pancreatic stent placement has a lower rate of pancreatitis than biliary sphincterotomy alone. Endoscopy 2002; 34:280-5.Fogel E.L., Eversman D., Jamidar P. et al. Sphincter of Oddi dysfunction: pancreaticobiliary sphincterotomy with pancreatic stent placement has a lower rate of pancreatitis than biliary sphincterotomy alone. Endoscopy 2002; 34:280-5.Geenen J.E. The efficacy of endoscopic sphincterotomy after cholecystectomy in patients with sphincter of Oddi dysfunction // New Engl. J. Med. - 1989. - Vol. 320. - P. 82-87.Geenen J.E. The efficacy of endoscopic sphincterotomy after cholecystectomy in patients with sphincter of Oddi dysfunction // New Engl. J. Med. - 1989. - Vol. 320. - P. 82-87.Gorelick A, Barnett J., Chey W. et al. Botulinum toxin injection after biliary sphincterotomy. Endoscopy 2004; 36:170-3.Gorelick A, Barnett J., Chey W. et al. Botulinum toxin injection after biliary sphincterotomy. Endoscopy 2004; 36:170-3.Jathal A, Sherman S., Fogel E.L. etal. Long-term clinical outcome of endoscopic pancreatobiliary sphincterotomy (pbes) versus biliary sphincterotomy (bes) alone in sphincter of oddi dysfunction associated with idiopathic recurrent pancreatitis Gastroint Endoscopy 2001 Vol. 53(5):AB93Jathal A, Sherman S., Fogel E.L. etal. Long-term clinical outcome of endoscopic pancreatobiliary sphincterotomy (pbes) versus biliary sphincterotomy (bes) alone in sphincter of oddi dysfunction associated with idiopathic recurrent pancreatitis Gastroint Endoscopy 2001 Vol. 53(5):AB93Hogan WJ, Geenen JE. Biliary dyskinesia. Endoscopy. 1988;20:179-183Hogan WJ, Geenen JE. Biliary dyskinesia. Endoscopy. 1988;20:179-183Lehman GA, Sherman S. Sphincter of Oddi dysfunction. In: Yamada T, Alpers DH, Laine L, Owyang C, Powell DW. editors. Textbook of gastroenterology. 3rd ed. Philadelphia:Lippincott Williams & Wilkins; 1999. p. 2343-54.Lehman GA, Sherman S. Sphincter of Oddi dysfunction. In: Yamada T, Alpers DH, Laine L, Owyang C, Powell DW. editors. Textbook of gastroenterology. 3rd ed. Philadelphia:Lippincott Williams & Wilkins; 1999. p. 2343-54.Manoukian AV, Schmalz MJ, Geenen JE et al. The incidence of post-sphincterotomy stenosis in group II patients with sphincter of Oddi dysfunction. Gastrointest Endosc 1993 39:496-8.Manoukian AV, Schmalz MJ, Geenen JE et al. The incidence of post-sphincterotomy stenosis in group II patients with sphincter of Oddi dysfunction. Gastrointest Endosc 1993 39:496-8.Park S-H., James L. W., Evan L.F. et al. Long-term outcome of endoscopic dual pancreatobiliary sphincterotomy in patients with manometry-documented sphincter of Oddi dysfunction and normal pancreatogram. Gastroint Endoscopy 2003 Vol. 57 (4): 483 - 491Park S-H., James L. W., Evan L.F. et al. Long-term outcome of endoscopic dual pancreatobiliary sphincterotomy in patients with manometry-documented sphincter of Oddi dysfunction and normal pancreatogram. Gastroint Endoscopy 2003 Vol. 57 (4): 483 - 491Petersen В.Т. Ai evidence-based review of sphincter of Oddi dysfunction: part I, presentations with «objective» biliary findings (types I and II) Gastrointestinal Endoscopy April 2004 Vol. 59, Issue 4, Pages 525-534Petersen В.Т. Ai evidence-based review of sphincter of Oddi dysfunction: part I, presentations with «objective» biliary findings (types I and II) Gastrointestinal Endoscopy April 2004 Vol. 59, Issue 4, Pages 525-534Petersen B.T. Sphincter of Oddi dysfunction, part2: evidence-based review of the presentations, with “objective" pancreatic findings (types I and II) and of presumptive type III. Gastrointestinal Endoscopy May 2004 Vol. 59, Issue 6, Pages 670-687Petersen B.T. Sphincter of Oddi dysfunction, part2: evidence-based review of the presentations, with “objective" pancreatic findings (types I and II) and of presumptive type III. Gastrointestinal Endoscopy May 2004 Vol. 59, Issue 6, Pages 670-687Ponchon Т., Ajcia N., Mitchell R. et al. Biopsies of the ampullary region in patients suspected to have sphincter of Oddi dysfunction. Gastrointest Endosc 1995;42:296-300.Ponchon Т., Ajcia N., Mitchell R. et al. Biopsies of the ampullary region in patients suspected to have sphincter of Oddi dysfunction. Gastrointest Endosc 1995;42:296-300.Rashdan A, Fogel E., McHenry L. etal. Frequency of biliary crystals in patients with suspected sphincter of Oddi dysfunction Gastrointest Endosc 2003 Vol.58 (6): 875 - 78Rashdan A, Fogel E., McHenry L. etal. Frequency of biliary crystals in patients with suspected sphincter of Oddi dysfunction Gastrointest Endosc 2003 Vol.58 (6): 875 - 78Rosenblatt ML, Catalano MF, Alcocer E, Geenen JE Comparison of sphincter of Oddi manometry, fatty meal sonography, and hepatobiliary scintigraphy in the diagnosis of sphincter of Oddi dysfunction. // Gastrointest Endosc. 2001 Dec;54(6):697-704Rosenblatt ML, Catalano MF, Alcocer E, Geenen JE Comparison of sphincter of Oddi manometry, fatty meal sonography, and hepatobiliary scintigraphy in the diagnosis of sphincter of Oddi dysfunction. // Gastrointest Endosc. 2001 Dec;54(6):697-704Sgouros S.N., Pereira S.P. Systematic review: sphincter of Oddi dysfunction-non-invasive diagnostic methods and long-term outcome after endoscopic sphincterotomy. Aliment Pharmacol Ther 2006; 24:237-46.Sgouros S.N., Pereira S.P. Systematic review: sphincter of Oddi dysfunction-non-invasive diagnostic methods and long-term outcome after endoscopic sphincterotomy. Aliment Pharmacol Ther 2006; 24:237-46.Sherman S., Troiano P.P., Hawes R.H. etal. Frequency of abnormal sphincter of Oddi manometry compared with the clinical suspicion of sphincter of Oddi dysfunction //Amer. J. Gastroenterol. - 1991. - Vol. 86. -P. 586-590Sherman S., Troiano P.P., Hawes R.H. etal. Frequency of abnormal sphincter of Oddi manometry compared with the clinical suspicion of sphincter of Oddi dysfunction //Amer. J. Gastroenterol. - 1991. - Vol. 86. -P. 586-590Sherman S., Ruffolo T.A, Hawes R.H., Lehman G.A Complications of endoscopic sphincterotomy. A prospective series with emphasis on the increased risk associated with sphincter of Oddi dysfunction and nondilated bile ducts. Gastroenterology 1991; 101:1068-75.Sherman S., Ruffolo T.A, Hawes R.H., Lehman G.A Complications of endoscopic sphincterotomy. A prospective series with emphasis on the increased risk associated with sphincter of Oddi dysfunction and nondilated bile ducts. Gastroenterology 1991; 101:1068-75.Sherman S. What is the role of ERCP in the setting of abdominal pain of pancreatic or biliary origin (suspected sphincter of Oddi dysfunction)? Gastrointest Endosc 2002 Vol. 56(6) (SUPPL): S258- S266.Sherman S. What is the role of ERCP in the setting of abdominal pain of pancreatic or biliary origin (suspected sphincter of Oddi dysfunction)? Gastrointest Endosc 2002 Vol. 56(6) (SUPPL): S258- S266.Silverman W.B., Slivka A, Rabinovitz М., Wilson J. Hybrid classification of sphincter of Oddi dysfunction based on simplified Milwaukee criteria: effect of marginal serum liver and pancreas test elevations. Dig Dis Sci 2001; 46:278-81.Silverman W.B., Slivka A, Rabinovitz М., Wilson J. Hybrid classification of sphincter of Oddi dysfunction based on simplified Milwaukee criteria: effect of marginal serum liver and pancreas test elevations. Dig Dis Sci 2001; 46:278-81.Smith M.T. Нарушение функции сфинктера Одди // Секреты гастроэнтерологии: Пер. с англ. - М.; СПб: БИНОМ, Невский диалект, 1998. - С. 357-372.Smith M.T. Нарушение функции сфинктера Одди // Секреты гастроэнтерологии: Пер. с англ. - М.; СПб: БИНОМ, Невский диалект, 1998. - С. 357-372.Toouli J., Craig A Sphincter of Oddi function and dysfunction // Can. J. Gastroenterol. - 2000. - № 14 (5). - P. 411-419.Toouli J., Craig A Sphincter of Oddi function and dysfunction // Can. J. Gastroenterol. - 2000. - № 14 (5). - P. 411-419.Varadarajulu S., Hawes R.H., Cotton P.B. Determination of sphincter of Oddi dysfunction in patients with prior normal manometry. Gastrointest Endosc 2003;58:341-4.Varadarajulu S., Hawes R.H., Cotton P.B. Determination of sphincter of Oddi dysfunction in patients with prior normal manometry. Gastrointest Endosc 2003;58:341-4.Wehrmann Т., Wiemer K., Lembcke B. et al. Do patients with sphincter of Oddi dysfunction benefit from endoscopic sphincterotomy? A 5-year prospective trial. Eur J Gastroenterol Hepatol 1996; 8:251-6.Wehrmann Т., Wiemer K., Lembcke B. et al. Do patients with sphincter of Oddi dysfunction benefit from endoscopic sphincterotomy? A 5-year prospective trial. Eur J Gastroenterol Hepatol 1996; 8:251-6.

The authors declare that there are no conflicts of interest present.