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Technique of transduodenal exploration of the common bile duct. Duodenoscopic appearances after biliary sphincterotomy.

A simple technique for performing biliary sphincterotomy is described. From an experience of 150 such operations this has been found to provide satisfactory access for exploring the biliary tree and makes T-tube drainage unnecessary. Duodenoscopic observation up to 9 years after the operation showed that the sphincteric region had healed without stenosis. Sphincteric activity had not been completely abolished.

Adult↗

A preliminary report: urgent duodenoscopic sphincterotomy for acute gallstone pancreatitis.

Eleven patients wtih gallstone-related acute pancreatitis underwent urgent duodenoscopy and diathermy sphincterotomy; six had stones impacted at the papilla of Vater, and the remainder had stones in the bile duct. One patient had a gallstone in the pancreatic duct. Endoscopic removal of the duct stones resulted in a prompt, persistent clinical and biochemical improvement, except in one patient who had been referred from another hospital with a pseudocyst 3 weeks after the onset of illness. Pancreatography results were remarkably normal in the remaining patients. Use of emergency biliary decompression in patients with acute gallstone-related pancreatitis remains controversial, and the indications need clarification. However our results justify further evaluation of duodenoscopic sphincterotomy as an alternative to surgery.

Acute Disease↗