Sleeve Sphincter Of Oddi (So) Manometry - Accurate And Safe

Perfused multilumen SO manometry is the “gold standard” for diagnosis of SO dysfunction. Concern exists regarding safety, and reliability for recording abnormalities, due to movement artefact. A 2 cm long 1.5 mm diameter sleeve assembly for recording SO motility was developed. The assembly is reverse perfused so that no fluid enters the ducts. This design may decrease the potential for pancreatitis. Aim: To compare recordings from the sleeve assembly with the standard triple lumen perfused manometry. Method: Total 30 studies were done in 27 patients with suspected SO dysfunction. In 19, studies were from the bile duct SO. In 13 of these, the SO was intact, whilst in 6 the SO had undergone previous sphincterotomy. In 11, studies were from the pancreatic duct SO. In 5 of these, the SO was intact, while in 6 the SO had undergone previous sphincterotomy. Elevated basal SO pressure was diagnosed in 11 of the 30 studies via triple lumen manometry. In 10 of 11 studies, elevated basal SO pressure was present via the sleeve assembly. There was no statistically significant difference in the recording of SO amplitude between the two techniques. A strong correlation exists between recordings of SO basal pressure made with the sleeve and triple lumen catheter (Figure). Recordings from the SO via sleeve assembly were associated with less movement artefact which made reading and interpretation of the recordings easy. One patient developed mild pancreatitis, which prolonged hospital stay by 1 day. Conclusion: The sleeve catheter records SO pressure comparable values to the standard triple lumen SO manometry. There is reduced artifact within an individual study. The sleeve assembly safe and potentially can replace the perfused triple lumen catheter.