Management of patients with sphincter of Oddi dysfunction based on a new classification

Table 3 Clinical classification and features of sphincter of Oddi dysfunction

Features	Bile duct type (type I)	Pancreatic duct type (type II)	Double-duct type (type III)	Biliary-pancreatic reflux type (type IV)
Abdominal pain	Retrosternal pain	Epigastric pain	I + II	Same as type II
Radiating pain	The central point of the back	The left back or indefinite site	I + II	Same as type II
Timing of onset	After high-fat meals	After ordinary meals	I + II	At night or in the morning
Jaundice	±	-	±	-
Liver enzyme levels	±	-	+	±
Serum amylase levels	-	+	±	+
Bile duct distension	≥ 10 mm	< 10 mm	≥ 10 mm	≥ 10 mm
Pancreatic duct distension	-	++	+	+
Anterograde cholangiography
Voiding time	> 10 min	Normal	> 10 min	Unexpected pancreatic duct visualization