The distal classification and management of choledochal cyst in. Technique of transduodenal exploration of the common bile. The intrabiliary pressures in six patients were abnormal, ranging from 210 to 230 mm ho normal, 80 to intraoperatively before the exploration of the common bile duct, but were found to be normal after the sphincteroplasty. Transduodenal sphincteroplasty tds offers permanent prophylaxis against further stones in the common bile duct cbd by allowing continuous free efflux of. The ampullary sphincter is enlarged, and any stones that are left behind in the upper ductal system should. All patients were followed up clinically and biochemically for from one to four years. Technique of transduodenal exploration of the common bile duct. Seven patients suffered operative complications, with one death. Full text is available as a scanned copy of the original print version. Laparoscopic transduodenal sphincteroplasty of the minor papilla. Pdf transduodenal sphincteroplasty and transampullary. Transduodenal sphincteroplasty in the management of. Sphincteroplasty is successful in more than 90% of patients with faecal incontinence due to sphincter injury, restoring most of them almost completely to normal.
Recurrent bile duct stones after transduodenal sphincteroplasty ncbi. Get a printable copy pdf file of the complete article 1. Society of american gastrointestinal and endoscopic surgeons sages 2,268 views. All patients underwent combined supraduodenal exploration of the common bile duct and transduodenal sphincteroplasty. Article pdf available in annals of the royal college of surgeons of england 841. Transduodenal sphincteroplasty jama surgery jama network. Bleeding could occur and may require a return to the operating room. Transduodenal sphincteroplasty with transampullary septectomy provides longterm benefit to carefully selected patients with chronic abdominal pain after cholecystectomy. Neoptolemos p ancreatic sphincteroplasty is used in the treatment of such conditions as recurrent idiopathic pancreatitis and postcholecystectomy pain caused by papillary dys function or papillary stenosis. Extraperitoneal sphincteroplasty for residual stones. Risks of transduodenal sphincteroplasty there are risks and complications with this procedure. An anatomical study of the choledochoduodenal area. Transduodenal sphincteroplasty and transampullary septectomy for sphincter of oddi dysfunction article pdf available in annals of the royal college of surgeons of england 841. Infection can occur, requiring antibiotics and further treatment.
The operation of transduodenal sphincteroplasty and pancreatic ductal. Results of sphincteroplasty authors year nb pts success % improved % fang 19844 76 82 89 browning and motson 19882 83 78 91 yoshioka 198924 27 47 79 wexner 199123. Pdf to determine the longterm results of choledochodudenostomy in patients. Links to pubmed are also available for selected references. A technique for transduodenal sphincteroplasty is presented. One type 3 patient underwent endoscopic sphincteroplasty, and another type 3 patient underwent transduodenal sphincteroplasty. Seventeen patients underwent a barium meal examination a year after surgery and of these patients, ten showed retrograde filling of the common bile duct and four had air in it. It produces a wide opening of the distal bile duct, allowing impacted stones to be removed from the ampulla of vater.
Sphincteroplasty was done via the extraperitoneal transduodenal approach in 42 patients. The indications were residual stones in 34 patients, stricture at oddis sphincter in seven patients, and relapsing pancreatitis in one patient. Pdf longterm results of choledochoduodenostomy in benign. To date, results in 123 consecutive patients have been excellent. For sphincteroplasty, the ampulla and distal cbd are divided for a distance of 1. Treatment may be by endoscopic papillotomy or sphincterotomy, joining the fistulous orifice. Laparoscopic transduodenal sphincteroplasty of the minor.
Full text full text is available as a scanned copy of the original print version. Ttube decompression of the common bile duct and subphrenic space drainage are routinely avoided. Transduodenal sphincteroplasty and transampullary septectomy for sphincter of oddi dysfunction. Rowlands royal victoria hospital and department of surgery, institute of clinical science, queens university of belfast, uk. Transduodenal sphincteroplasty sphincteroplasty is a useful adjunct to bile duct exploration for calculous biliary tract disease. Multidisciplinary management of common bile duct stones.
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