The author reports the results obtained from January 1965 to December 1974 with the routine use of wide transduodenal papillosphincterotomy, both in diseases of Oddi's sphincter and in bile duct lithiasis. He describes carefully the operation in which he attacked the papilla directly after opening the duodenum and hence performed a primary transduodenal papillosphincterotomy, which avoids opening the common bile duct, even in cases of cholelithiasis; hence, one may avoid trauma to the sphincter of Oddi and a T tube drain is unnecessary. The author has always carried out wide sphincterotomy (on average 17-18 mm) and, in view of the results obtained, he considers the method valid. In 10 years' experience he has operated on 411 cases of wide primary transduodenal papillosphincterotomy, and he discusses the results, comparing them with those obtained previously by other methods, including choledochoduodenostomy. There were 2 operative deaths (0.5%), 1 case of cholangitis (0.25%), and 7 cases of death from other causes. There was no case of pancreatitis, nor relapse of the stenosis, nor relapse of the lithiasis. 401 cases had excellent long term results.
LA PAPILLOSPHINCTEROTOMIE TRANSDUODENALE PRIMAIRE AMPLE ODDIENNE EN CHIRURGIE BILIAIRE(10 ANNEES D'EXPERIENCE, 411 CAS OPERES)
NORBERTO, LORENZO
1978
Abstract
The author reports the results obtained from January 1965 to December 1974 with the routine use of wide transduodenal papillosphincterotomy, both in diseases of Oddi's sphincter and in bile duct lithiasis. He describes carefully the operation in which he attacked the papilla directly after opening the duodenum and hence performed a primary transduodenal papillosphincterotomy, which avoids opening the common bile duct, even in cases of cholelithiasis; hence, one may avoid trauma to the sphincter of Oddi and a T tube drain is unnecessary. The author has always carried out wide sphincterotomy (on average 17-18 mm) and, in view of the results obtained, he considers the method valid. In 10 years' experience he has operated on 411 cases of wide primary transduodenal papillosphincterotomy, and he discusses the results, comparing them with those obtained previously by other methods, including choledochoduodenostomy. There were 2 operative deaths (0.5%), 1 case of cholangitis (0.25%), and 7 cases of death from other causes. There was no case of pancreatitis, nor relapse of the stenosis, nor relapse of the lithiasis. 401 cases had excellent long term results.
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