Modern concepts of sphincter of Oddi pancreatic dysfunction
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sphincter of Oddi, anatomy, dysfunction, Rome recommendations IV, diagnosis, treatment

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Gubergrits, N. B., Byelyayeva, N. V., Klochkov, A. Y., Lukashevich, G. M., Rakhmetova, V. S., Fomenko, P. G., Yurjeva, A. V., & Yaroshenko, L. A. (2019). Modern concepts of sphincter of Oddi pancreatic dysfunction. Herald of Pancreatic Club, 42(1), 30-35.

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History of study of the sphincter of Oddi (SO) is presented in a detail in the article, attention is paid to the anatomical and functional relationships of SO with the gallbladder, duodenum and pancreas. The role of SO dysfunction in the pathogenesis of pancreatitis and biliary dysfunction is described in detail, previous and modern ideas about SO pancreatic disfunction are considered. The historical features of the introduction of the term “dyspancreatism” are given, the clinical peculiarities and periods of its occurrence are listed, the pathogenetic relationship of dyspancreatism with other functional disorders, including functional dyspepsia, is described. Provisions of the IV Roman consensus are considered, confirming the relationship of pancreatic dysfunction with the occurrence of pancreatic pain and pancreatitis itself. The criteria for the diagnostics of pancreatic type SO dysfunction, formulated in the modern Rome recommendations for the diagnosis and treatment of functional gastroenterological disorders, are presented. Standard and alternative diagnostic tests are listed, which conduction will confirm the SO dysfunction. Modern approaches to the treatment of SO dysfunction are analyzed, focusing on the use of invasive treatment methods, the advantages and disadvantages of biliary and pancreatic sphincterotomy are revealed, the inexpediency of performing the endoscopic retrograde cholangiopancreatography in patients with single episode of idiopathic acute pancreatitis is proved. The need for a balanced and cautious approach to the use of invasive methods for the treatment of SO dysfunction is emphasized; prospects for further study of the pathology of this sphincter are described.
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