Feature Study
Evaluating Predictors & Interventions in Sphincter of Oddi Dysfunction
(EPISOD)
Peter Cotton, MD FRCP
FRCS, Prof. of Medicine
Dr. Peter B. Cotton is MUSC’s Principal
Investigator in the NIH-funded study on a treatment for stenosis of
the sphincter, a painful dysfunction that can occur following gall
bladder surgery.
The sphincter of Oddi is a valve
controlling the flow of bile and pancreatic juices into the
duodenum. Stenosis (a narrowing) of the sphincter can cause
recurrent attacks of pain after surgical removal of the gall
bladder. Diagnosis and management of this condition is
controversial. Many patients are referred to tertiary centers for
Endoscopic Retrograde Cholangiopancreatography (ERCP) with manometry.
However, the results of manometry-guided sphincterotomy are not
optimal and there are significant risks of developing pancreatitis
in as many as 10% of patients.
The EPISOD study (Evaluating Predictors
of Interventions in Sphincter of Oddi Dysfunction), for which our goal is to enroll 250 subjects, has been designed
to evaluate which patients respond to sphincterotomy, their clinical
characteristics (e.g., their pain patterns and presence of other
functional or psychiatric disorders), and the relevance of manometry.
In addition to MUSC, there are seven other
collaborating centers: Seattle, Minneapolis,
Indianapolis, St. Louis, Dallas, Yale and Los Angeles.
Further details and contact personnel are available here.