10yrs Post-Op and Sphincter of Oddi Disorder/Pancreatitis

I've been battling with pancreatitis and liver issues since about 2yrs post op. I recently saw a pancreas specialist who believes I have SOD or Sphincter of Oddi D/O. He said it's normally an easy fix, but because of the RNY GB, he really would not want to do the surgery on me. It's apparently normally something they can do through an endoscope, but not in a bypass patient. He gave me some meds to try to help with the pain but I've tried them before... wondering if I should seek out a second opinion.

Yep, I would. Yes, you may have to have open surgery, but why would he not do it?

Good luck finding another specialist

If he's not able or willing to help you then definitely keep looking for a doctor who will. Look for a second or even a third if you have to.

Good God. You've been dealing with that for eight years? Not sure how you are still standing; I know I wouldn't be.

You need to find a different surgeon. They can't always operate, but the reason they won't should be a lot more than an arbitrary reference to your RnY. Did that surgeon give you specifics as to exactly what about your bypass contraindicated surgery? I'd get at least two more different opinions before giving up on the surgery option.

And I really, really hope you can get this taken care of soon. The pain must be debilitating.

I recommend you contact the following surgeon for a video consultation. Wouldn't hurt to get a second opinion. He is a great bariatric surgeon but is also amazing at diagnosing and treating complex abdominal issues. I had surgery with him recently that surgeons in my home state could not address properly.

Ara Keshishian, MD, FACS, FASMBS

Phone: 818-812-7222

10 Congress St, Ste 300

Pasadena, CA 91105

get second opinion- I went through this early this year. liver numbers were all wonky- they thought i had SOD. i didn't though---check a few different places. My surgeon was willing to go into my remnant stomach and go that way to fix- he would have to work with a gastro dr to fix it.

I have SOD. It's horrible. I had it long before my surgery but I recognize I'm lucky in that mine seems to only flare from a long list of narcotics (codeine, morphine, Dilauded and tramacet). I couldn't take anything but Tylenol recovering from the RNY and I had painful complications. I have read that WLS is associated with the onset of SOD (as is gallbladder removal). I'm truly sorry you are dealing with this awful disorder. I would seek out another opinion. You are correct about the procedure (I'm guessing it's an ERCP) being complex after RNY. A surgeon could conceivably do a laparoscopic ERCP but it's slready a risky procedure. Also, I'm in. Facebook support group for SOD and many have had the ERCP and a sphincterotomy, where the muscle is cut to open up the closing. Some people get long term relief but so many people in the group say it didn't help or helped for a limited time (eg a few weeks to a few years). Several people have discussed visceral manipulation for SOD and have had very good success. Something to do with the vagus nerve. I don't know what that would look like for someone post RNY but might be worth looking into to get some relief!

Ditto on what everyone said about getting a second opinion and yes Dr. Ara Keshishian is the BEST! Call them and please keep us posted on how things are going.

I saw a liver specialist (bariatric surgeon referred me) about 4 years ago that told me he couldn't do the ERCP because of my RNY. He said he could put in a feeding type tube in my abdomen, let it heal, and then go through that opening and work the scope from the bottom up to liver/pancreas. He said it was a very risky procedure and may cause acute pancreatitis. He wanted me to just use pain meds (narcotics) for the episodes until it got to a point that the episodes were so frequent or the pain meds weren't working.

I have about 2 episodes a month and the narcotics take care of pain after one or two doses. I avoid anything oily or fatty as that seems to make an episode flair up.

Wish you the best and I hope I never get to the point that I need anything else done.

Penny

Thanks for the advice. Unfortunately the hospital system that my doctor is in no longer prescribes narcotics for anything except surgery, trauma like a broken bone, or cancer. For now, I'm just stuck dealing with it so n my own.