[Transduodenal sphincteroplasty of the Oddi-Boyden for free bilio-pancreatic flow].
In 58 patients we performed transduodenal sphincteroplasty to show the effectiveness of this procedure in patients with stenosis of the sphincter of Oddi-Boyden, choledocholithiasis and biliary pancreatitis with follow up ranging from 14 months to 11 years 3 months. The sphincteroplasty was performed in 33 cases (27%) for stenosis, in 13 cases (22%) for biliary pancreatitis and in 12 cases (12%) for choledocholithiasis. All cases with the exception of one had cholelithiasis or choledocholithiasis. In 39 patients (67%) the cholangiography performed before the sphincteroplasty demonstrated a common bile duct with average diameter of 1.6 cm. On the first, third and fifth postoperative examination of serum bilirubin and amylase showed a progressive decrease, implying free flow through the common bile duct. Post operative cholangiography confirmed free flow of contrast trough the common bile duct into the duodenum (p < 0.05). The morbidity and mortality were 24.5% and 1.7% respectively. The results were bad in 2 cases, fair in one case, and excellent in 55 cases (94.6%); which were completely free of symptoms postoperatively. We conclude that transduodenal sphincteroplasty of the sphincter of Oddi-Boyden is a useful procedure to reestablish free biliary flow in cases of stenosis, choledocholithiasis and biliary pancreatitis.
Azabache Puente
W
W
Departamento de Cirugía-Universidad Nacional de Trujillo, Cirujano del Hospital Regional Docente, Trujillo, Peru.
Vela Saavedra
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003137:Common Bile Duct Diseases / Q000503:physiopathology / Q000601:surgery; D003251:Constriction, Pathologic / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012086:Reoperation; D009803:Sphincter of Oddi / Q000503:physiopathology; D013105:Sphincterotomy, Transduodenal / Q000379:methods
Esfinteroplastía transduodenal del Oddi-Boyden para libre flujo bilio-pancreático.