Sphincteroplasty of the Sphincter of Oddi in the Treatment of Benign Distal Obstructions of the Bile Duct

Seventy patients in whom sphincteroplasty was performed by an original technique are presented. In 65 cases the indication was stenosis of the sphincter of oddi, associated or not with cholelithiasis or hepatic hydatid disease. There were relative indications in another 5 patients. Sphincteroplasty was achieved with the aid of an original probe, and average length of the incision of the ampullary area was 28 mm. In the immediate postoperative period there was one case of acute postoperative pancreatitis, one duodenal fistula and an upper digestive haemorrhage; also a residual stone was detected. All these complications have responded favourably to conservative treatment. There was a single death in an old patient with bronchopneumonia. The late results were very good or good with the exception of two cases: one which presented with cholangitis episodes maintained by duodenal stasis, and one female patient, who after one year from sphincteroplasty had to be reoperated on for an hepatic abscess.