title: Transduodenal sphincteroplasty with transampullary septectomy for stenosing papillitis.
abstract: The papilla of Vater and its sphincter of Oddi, lying at the confluence of the bile and pancreatic ducts in man, have long been suspected as a source of upper abdominal pain. Enlarging the opening of the transpapillary segment of the bile and major pancreatic ducts by using a transduodenal sphincteroplasty with transampullary septectomy resulted in death in a patient with a peripapillary diverticulum and pancreas divisum. Eight-six patients followed for 1 to 10 years experienced a 75% success rate. Thirty-six patients had a marked stenosis of their duct of Wirsung, suggesting that their pain was primarily from the pancreas. The remainder had either a generalized narrowing (40 patients) or a normal (7 patients) papilla. Pain was not satisfactorily resolved in patients with an associated pancreas divisum, chronic pancreatitis, and recurrent episodes of acute pancreatitis with alcoholism.
authors.affiliation: Department of Surgery, University of Texas Medical School, Houston 77030.
authors.forename: F G
authors.initials: FG
authors.lastname: Moody
authors.forename: R
authors.initials: R
authors.lastname: Vecchio
authors.forename: R
authors.initials: R
authors.lastname: Calabuig
authors.forename: N
authors.initials: N
authors.lastname: Runkel
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D014670:Ampulla of Vater / Q000601:surgery*; D002761:Cholangitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002763:Cholecystectomy; D003251:Constriction, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D013105:Sphincterotomy, Transduodenal / Q000379:methods*