Abstract: As diagnosis of sphincter of Oddi (SO) dysfunction may require perendoscopic manometric assessment of the sphincter, which is an invasive technique carrying a significant risk of pancreatitis, non-invasive scintigraphy has been proposed as an alternative diagnostic method. Craig et al (Gut 2003; 52 :352–7) reported their experience in assessing SO dysfunction in post-cholecystectomy patients with scintigraphy using the hepatic hilum-duodenum transit time (HHDT) of Cicala and colleagues1 and the scoring system of Sostre and colleagues.2 In the study of Craig et al , scintigraphic data after cholecystokinin octapeptide (CCK-OP) infusion were compared with SO basal pressure, the latter recorded at manometry in the absence of any stimulus.
Craig et al concluded that none of the above scintigraphic variables was sufficiently sensitive to diagnose SO dysfunction identified at SO manometry. Although it is evident that the scintigraphic method of Craig et al used in their study was indeed poorly sensitive, the conclusion of their study cannot be extended to interpret the validity of scintigraphy, as performed in other centres.
It is …