Sphincter of Oddi (SOD) Manometry

What is an ERCP with manometry?
This is an endoscopic procedure used to evaluate the ducts of the gallbladder, liver and pancreas, and determine the pressure of the Sphincter of Oddi, the muscle that is at the end of those ducts. A small catheter is placed into the bile duct during the procedure. This catheter measures the pressure in the sphincter. If the pressure is more than normal sphincter pressure, Dr.Ahmed may make a small incision in that sphincter, a sphincterotomy. If there are any other abnormalities of the sphincter or ducts, biopsies or brushings may be taken. And if a stone or sludge is present in the duct, Dr. Ahmed will remove this. If the duct is narrowed, a temporary stent may be placed.

Why is an ERCP with manometry done?
This is done to evaluate abnormal lab values, unexplained upper abdominal pain and nausea, and ductal dilation. 

How should I prepare for an ERCP with manometry?
You will need to fast for the procedure. If you are on blood thinners, the office will contact you ahead of time to discuss holding them prior to the procedure. Usually you will stay overnight in the hospital after the procedure.

What can I expect during an ERCP with manometry?
You will be sedated during the procedure, so you should not experience any discomfort or have any memory of the procedure.

What should I expect after manometry?
You will likely stay overnight in the hospital to manage any symptoms from the procedure, and watch for any complications. Usually, you will be discharged home the following day. Sometimes Dr.Ahmed places a temporary stent during the procedure, either in the pancreatic or bile duct, or both. If he does place a stent, depending on what type of stent it is, the stent may be removed a couple of weeks to couple of months later. This is usually done at MESC, and is done under sedation with an endoscope.

What are the possible complications of ERCP with manometry?
ERCP with manometry sometimes causes a temporary flare of a patient’s previous symptoms. If this occurs, sometimes the patient will stay for more than one night in the hospital to help manage the flare. Occasionally, pancreatitis develops, which is a painful inflammation of the pancreas. Less common complications are infection, perforation, bleeding, sedation complications, or fluid collections from pancreatitis.