Peter B Cotton, Valerie Durkalski, Joseph Romagnuolo, Qi Pauls, Evan Fogel, Paul Tarnasky, Giuseppe Aliperti, Martin Freeman, Richard Kozarek, Priya Jamidar, Mel Wilcox, Jose Serrano, Olga Brawman-Mintzer, Grace Elta, Patrick Mauldin, Andre Thornhill, Robert Hawes, April Wood-Williams, Kyle Orrell, Douglas Drossman, Patricia Robuck
IMPORTANCE: Abdominal pain after cholecystectomy is common and may be attributed to sphincter of Oddi dysfunction. Management often involves endoscopic retrograde cholangiopancreatography (ERCP) with manometry and sphincterotomy. OBJECTIVE: To determine whether endoscopic sphincterotomy reduces pain and whether sphincter manometric pressure is predictive of pain relief. DESIGN, SETTING, AND PATIENTS: Multicenter, sham-controlled, randomized trial involving 214 patients with pain after cholecystectomy without significant abnormalities on imaging or laboratory studies, and no prior sphincter treatment or pancreatitis randomly assigned (August 6, 2008-March 23, 2012) to undergo sphincterotomy or sham therapy at 7 referral medical centers...
May 2014: JAMA