Evidence map›Paper›PMID 39244217›Full record

ArticleGut2024

Sphincterotomy for biliary sphincter of Oddi disorder and idiopathic acute recurrent pancreatitis: the RESPOnD longitudinal cohort.

Gregory A Coté, Badih Joseph Elmunzer, Haley Nitchie, Richard S Kwon, Field Willingham, Sachin Wani, Vladimir Kushnir, Amitabh Chak, Vikesh Singh, Georgios I Papachristou and 8 more

Abstract readMulticenter Study
In one paragraph

Article in Gut, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Observational
  2. Review
  3. Article
  4. Article
  5. Endoscopic Management of Recurrent Acute Pancreatitis.Journal of clinical medicine · 2025
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Gregory A CotéDepartment of Medicine, Division of Gastroenterology & Hepatology, Oregon Health & Science University, Portland, Oregon, USA coteg@ohsu.edu.ORCID 0000-0002-3565-9302
Badih Joseph ElmunzerGastroenterology, Medical University of South Carolina, Charleston, South Carolina, USA.ORCID 0000-0002-9389-1927
Haley NitchieDepartment of Medicine, Division of Gastroenterology & Hepatology, Medical University of South Carolina, Charleston, South Carolina, USA.
Richard S KwonMedicine/Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.
Field WillinghamDivision of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.
Sachin WaniSchool of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA.ORCID 0000-0002-2935-0560
Vladimir KushnirWashington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
Amitabh ChakDivision of Gastroenterology and Liver Disease, University Hospitals Case Medical Center, Cleveland, Ohio, USA.ORCID 0000-0002-0021-7862
Vikesh SinghGastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, USA.ORCID 0000-0002-7577-3521
Georgios I PapachristouDepartment of Medicine, Division of Gastroenterology & Hepatology, The Ohio State University, Columbus, Ohio, USA.
Adam SlivkaMedicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Martin FreemanUniversity of Minnessota, Minneapolis, Minnesota, USA.
Srinivas GaddamCedars-Sinai Medical Center, Los Angeles, California, USA.
Priya JamidarDepartment of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Paul TarnaskyMethodist Digestive Institute, Dallas, Texas, USA.
Shyam VaradarajuluDigestive Health Institute, Orlando, Florida, USA.
Lydia D FosterDepartment of Public Health Science, Medical University of South Carolina, Charleston, South Carolina, USA.
Peter CottonMedicine, DDC, Medical University of South Carolina, Charleston, South Carolina, USA.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Results of Ercp in Sphincter of Oddi DysfunctionR01DK115495 · NIDDK · OREGON HEALTH & SCIENCE UNIVERSITY · PI COTE, GREGORY A, COTTON, PETER B · 2017 to 2021
$1.4M
NCATS NIH HHS UL1 TR001863NIDDK NIH HHS R01 DK115495
6 · The paper itself

Abstract

objectiveSphincter of Oddi disorders (SOD) are contentious conditions in patients whose abdominal pain, idiopathic acute pancreatitis (iAP) might arise from pressurisation at the sphincter of Oddi. The present study aimed to measure the benefit of sphincterotomy for suspected SOD.

designProspective cohort conducted at 14 US centres with 12 months follow-up. Patients undergoing first-time endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy for suspected SOD were eligible: pancreatobiliary-type pain with or without iAP. The primary outcome was defined as the composite of improvement by Patient Global Impression of Change (PGIC), no new or increased opioids and no repeat intervention. Missing data were addressed by hierarchal, multiple imputation scheme.

resultsOf 316 screened, 213 were enrolled with 190 (89.2%) of these having a dilated bile duct, abnormal labs, iAP or some combination. By imputation, an average of 122/213 (57.4% (95% CI 50.4% to 64.4%)) improved; response rate was similar for those with complete follow-up (99/161, 61.5% (54.0% to 69.0%)); of these, 118 (73.3%) improved by PGIC alone. Duct size, elevated labs and patient characteristics were not associated with response. AP occurred in 37/213 (17.4%) at a median of 6 months post ERCP and was more likely in those with a history of AP (30.9% vs 2.9%, p<0.0001).

conclusionNearly 60% of patients undergoing ERCP for suspected SOD improve, although the contribution of a placebo response is unknown. Contrary to prevailing belief, duct size and labs are poor response predictors. AP recurrence was common and like observations from prior non-intervention cohorts, suggesting no benefit of sphincterotomy in mitigating future AP episodes.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradePancreatitisRecurrenceSphincter of Oddi DysfunctionSphincterotomy, EndoscopicAcute DiseaseAdultAgedFemaleHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesSphincter of OddiTreatment OutcomeABDOMINAL PAINACUTE PANCREATITISENDOSCOPIC RETROGRADE PANCREATOGRAPHYENDOSCOPIC SPHINCTEROTOMYFUNCTIONAL BOWEL DISORDER

Identifiers

PMID39244217
PMCPMC11631645

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.