Evaluating the efficacy of endoscopic sphincterotomy on biliary-type sphincter of Oddi dysfunction: A retrospective clinical trial

Table 1 General information of biliary-type sphincter of Oddi dysfunction patients

Characteristic	Type I, n = 29	Type IIa, n = 6	Type IIb, n = 44
Sex (male/female)	8/21	4/2	15/29
Age [mean (SD), yr]	59.10 ± 17.36	56.00 ± 19.03	58.84 ± 11.14
With FH (n)	1	0	4
With IBS (n)	0	0	2
With FD (n)	1	1	3
ALT [M (IQR), U/L]	209.90 (121.55-361.39)	170.02 (110.25-203.36)	25.65 (16.75-66.50)
AST [M (IQR), U/L]	194.66 (75.90-345.50)	136.78 (48.81-175.61)	28.00 (22.32-360.06)
TBIL [M (IQR), mg/dL]	4.52 (3.13-8.13)	6.09 (4.24-11.23)	1.69 (1.15-3.12)
ALP [M (IQR), U/L]	199.44 (155.73-311.78)	354.70 (201.68-470.88)	98.20 (78.20-117.40)
Bile duct diameter [M (IQR), cm]	1.20 (1.00-1.50)	0.80 (0.78-0.80)	1.50 (1.10-2.00)

FD: Functional dyspepsia; FH: Functional heartburn; IBS: Irritable bowel syndrome; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; TBIL: Total bilirubin; SD: SD; M; Median; IQR: Interquartile range.

Table 2 Verbal rating scale-5 scoring system

0 points	No pain
1 point	Mild pain that is tolerable with normal life and sleep
2 points	Moderate pain that can interfere with proper sleep and requires analgesics
3 points	Severe pain and disturbed sleep that require anesthesia and analgesics
4 points	Severe pain causing severe interference with sleep accompanied by other symptoms or passive posture

Table 3 Verbal rating scale-5 scores before endoscopic sphincterotomy in biliary-type sphincter of Oddi dysfunction patients

Biliary-type SOD	0 points	1 point	2 points	3 points	4 points
Type I, n	0	0	0	26	3
Type II, n	0	0	0	43	7
Total, n	0	0	0	69	10

SOD: Sphincter of Oddi dysfunction patients.

Table 4 Endoscopic retrograde cholangiopancreatography intraoperative situation

Successful intubation rate	n = 79
EST	79
With ENBD	66
With EPBD	21
With ERBD	8
With ERPD	4
The average CBD in cm	1.4 (range: 1.0-1.8)
The average EST incision length in cm	0.52 ± 0.16

SOD: Sphincter of Oddi dysfunction; ERBD: Endoscopic retrograde biliary drainage; ERPD: Endoscopic retrograde pancreatic drainage; ENBD: Endoscopic nasobiliary drainage; CBD: Common bile duct diameter; EST: Endoscopic sphincterotomy; EPBD: Endoscopic papillary balloon dilation.

Table 5 Comparison of serum index results before and after endoscopic sphincterotomy in biliary-type sphincter of Oddi dysfunction patients

Serum index1	Biliary-type SOD		P value
	Pre-EST	Post-EST
ALT [M (IQR), U/L]	70.00 (24.10-190.03)	29.22 (18.00-58.00)	< 0.001
AST [M (IQR), U/L]	61.51 (26.08-157.79)	30.59 (22.00-64.00)	< 0.001
TBIL [M (IQR), mg/dL]	2.98 (1.49-5.02)	2.00 (1.14-3.03)	0.004
ALP [M (IQR), U/L]	129.00 (91.50-220.91)	7.60 (3.70-12.30)	< 0.001

¹The serum index was 1 wk before and after endoscopic sphincterotomy.

SOD: Sphincter of Oddi dysfunction; EST: Endoscopic sphincterotomy; ALT: Alanine aminotransferase (Reference range: 5-40 U/L); AST: Aspartate aminotransferase (Reference range: 8-40 U/L); ALP: Alkaline phosphatase (Reference range: 40-110 U/L); TBIL: Total bilirubin (Reference range: 1.71-17.1 U/L).

Table 6 Comparison of verbal rating scale-5 before and after endoscopic sphincterotomy in sphincter of Oddi dysfunction patients

Biliary-type SOD	Period	0 points	1 point	2 points	3 points	4 points	P value
Type I (n)	Pre-EST	0	0	0	26	3	< 0.001
	Post-EST	24	5	0	0	0
Type II (n)	Pre-EST	0	0	0	43	7	< 0.001
	Post-EST	43	1	2	4	0

SOD: Sphincter of Oddi dysfunction; EST: Endoscopic sphincterotomy.

Table 7 Comparison of verbal rating scale-5 before and after endoscopic sphincterotomy in Type IIa/b sphincter of Oddi dysfunction patients

Biliary-type SOD	Period	0 points	1 point	2 points	3 points	4 points	P value
Type IIa (n)	Pre-EST	0	0	0	6	0	< 0.001
	Post-EST	6	0	0	0	0
Type IIb (n)	Pre-EST	0	0	0	37	7	< 0.001
	Post-EST	37	1	2	4	0

SOD: Sphincter of Oddi dysfunction; EST: Endoscopic sphincterotomy.

Table 8 Curative effect of biliary-type sphincter of Oddi dysfunction patients

Biliary-type SOD	Obviously effective	Effective		Ineffective		Total, n	Overall effectiveness, %
	0 points	1 point	2 points	3 points	4 points
Type I, n	24	5	0	0	0	29	100.0
Type II, n	43	1	2	4	0	50	92.0

Overall effectiveness (%) = (Obviously effective + Effective)/Total × 100%. SOD: Sphincter of Oddi dysfunction.

Table 9 Curative effect of Type IIa/b sphincter of Oddi dysfunction patients

Biliary-type SOD	Obviously effective	Effective		Ineffective		Total, n	Overall effectiveness, %
	0 points	1 point	2 points	3 points	4 points
Type IIa, n	6	0	0	0	0	6	100
Type IIb, n	37	1	2	4	0	44	90.9

Overall effectiveness (%) = (Obviously effective + Effective)/Total × 100%. SOD: Sphincter of Oddi dysfunction.

Table 10 Comparison of verbal rating scale-5 scores of biliary-type sphincter of Oddi dysfunction patients (with/without functional gastrointestinal disorders) before and after endoscopic sphincterotomy

Period	Case	0 points, n	1 point, n	2 points, n	3 points, n	4 points, n	P value
Pre-EST	With FGID	0	0	0	10	2	0.271
	Without FGID	0	0	0	59	8
Post-EST	With FGID	1	0	0	7	4	< 0.001
	Without FGID	66	1	0	0	0

FGID: Functional gastrointestinal disorders; EST: Endoscopic sphincterotomy.