Abstract
Patients with disorders of the pancreaticobiliary junction or common bile duct (CBD) stones were predominantly evaluated and treated with surgical transduodenal sphincteroplasty, before the introduction of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) (Morgan et al., J Am Coll Surg. 206:908–914, 2008). However, there remain a subset of patients in whom this operation is indicated. In this chapter, we describe the technique used for a transduodenal sphincteroplasty as well as for mucosal resection of a periampullary adenoma with CBD sphincteroplasty and pancreatic duct septoplasty. Indications, preoperative preparation, pitfalls and danger points, operative strategy and technique, postoperative care, and complications are discussed.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Anderson TM, Pitt HA, Longmire WP, et al. Experience with sphincteroplasty and sphincterotomy in pancreatobiliary surgery. Ann Surg. 1985;201(4):399–406.
Cameron JL, Sandone C. In: Cameron JL, Sandone C, editors. Atlas of gastrointestinal surgery. 2nd ed. Hamilton: BC Decker Inc; 2007. p. 32–6.
Furukawa H, Iwata R, Moriyama N, Kosuge T. Blood supply to the pancreatic head, bile duct, and duodenum: evaluation by computed tomography during arteriography. Arch Surg. 1999;134:1086–90.
Kelly SB, Rowlands BJ. Transduodenal sphincteroplasty and transampullary septectomy for papillary stenosis. HPB Surg. 1996;9(4):199–207.
Madura JA, Madura JA. Diagnosis and management of sphincter of Oddi dysfunction and pancreas divisum. Surg Clin North Am. 2007;87(6):1417–29.
Miccini M, Bonapasta SA, Gregori M, Bononi M, Fornasari V, Tocchi A. Indications and results for transduodenal sphincteroplasty in the era of endoscopic sphincterotomy. Am J Surg. 2010;200(2):247–51.
Moody FG, Vecchio R, Calabuig R, Runkel N. Transduodenal sphincteroplasty with transampullary septectomy for stenosing papillitis. Am J Surg. 1991;161(2):213–8.
Morgan KA, Romagnuolo J, Adams DB. Transduodenal sphincteroplasty in the management of sphincter of Oddi dysfunction and pancreas divisum in the modern era. J Am Coll Surg. 2008;206(5):908–14.
Stefanini P, Carboni M, Patrassi N, De Bernardinis G, Negro P, Loriga P. Transduodenal sphincteroplasty. Its use in the treatment of lithiasis and benign obstruction of the common duct. Am J Surg. 1974;128(5):672–7.
Further Reading
Akoglu M, Sahin B, Davidson BR. Extended transduodenal sphincteroplasty for bile duct stones associated with a periampullary diverticulum. Postgrad Med J. 1992;68(799):346–9.
Makary MA, Elariny HA. Laparoscopic transduodenal sphincteroplasty. J Laparoendosc Adv Surg Tech A. 2006;16(6):629–32.
Tzovaras G, Rowlands BJ. Transduodenal sphincteroplasty and transampullary septectomy for sphincter of Oddi dysfunction. Ann R Coll Surg Engl. 2002;84(1):14–9.
Acknowledgments
The authors thank Jennifer Brumbaugh for her superb original illustration (Fig. 91.2).
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Sooppan, R., Yeo, C.J. (2022). Sphincteroplasty. In: Scott-Conner, C.E.H., Kaiser, A.M., Nguyen, N.T., Sarpel, U., Sugg, S.L. (eds) Chassin's Operative Strategy in General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-81415-1_91
Download citation
DOI: https://doi.org/10.1007/978-3-030-81415-1_91
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-81414-4
Online ISBN: 978-3-030-81415-1
eBook Packages: MedicineMedicine (R0)