Trial reportSurgical endoscopy2011
Botulinum toxin-induced relaxation of the sphincter of Oddi may select patients with acalculous biliary pain who will benefit from cholecystectomy.
Trial report in Surgical endoscopy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Therapeutic Upper Gastrointestinal Endoscopy in Pediatric Gastroenterology.Frontiers in pediatrics · 2021Pooled it
- Gastrointestinal Uses of Botulinum Toxin.Handbook of experimental pharmacology · 2021Trial
- Current treatment of biliary Sphincter of Oddi Dysfunction.Frontiers in medicine · 2024Review
- Botulinum Toxin A Use in the Gastrointestinal Tract: A Reappraisal After Three Decades.Gastroenterology & hepatology · 2023Article
- Translational and clinical perspectives on sphincter of Oddi dysfunction.Clinical and experimental gastroenterology · 2016Review
- Sphincter of Oddi Dysfunction: Updates from the Recent Literature.Current gastroenterology reports · 2015Review
- Review
- Normokinetic biliary dyskinesia: a novel diagnosis.Surgical endoscopy · 2012Article
- Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcalculous biliary pain may be due to gallbladder dyskinesia or sphincter of Oddi (SO) hypertension. These two etiologies are difficult to differentiate because the gallbladder ejection fraction may be low and the SO manometry results may be abnormal in both. Cholecystectomy is advised for patients with biliary dyskinesia, but it often exacerbates biliary pain for patients with SO hypertension. The biliary pain response to relaxation of the SO using botulinum toxin may indicate appropriate treatment for patients with acalculous biliary pain.
methodsThe protocol-based management of 25 patients with acalculous biliary pain and two gallbladder ejection fraction estimations less than 40% who had 100 units of botulinum toxin injected into their SO musculature to relax the sphincter has been audited. Patients whose pain was temporarily relieved after botulinum toxin injection were offered endoscopic biliary sphincterotomy, and patients who failed to experience benefit after botulinum toxin injection were assessed for laparoscopic cholecystectomy.
resultsBotulinum toxin was injected into the SO of 25 patients, with 11 experiencing temporary biliary pain relief. Of these patients, 10 consented to undergo endoscopic biliary sphincterotomy, with relief of biliary pain in all cases. A total of 14 patients had a negative response to botulinum toxin treatment, with 10 of these patients progressing to laparoscopic cholecystectomy, which resulted in biliary pain relief in eight cases.
conclusionBotulinum toxin-induced relaxation of the SO may help to direct appropriate therapy for patients with acalculous biliary pain. The data from this study supports the establishment of a randomized clinical trial.
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