Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 10 , ISSUE 1 ( January-April, 2021 ) > List of Articles

CASE REPORT

A Case Report: Regarding Transduodenal Sphincteroplasty

Maria S Ordonez, Jorge A Arteaga, Amber N Himmler, Jeovanni Reinoso, Juan C Salamea

Citation Information : Ordonez MS, Arteaga JA, Himmler AN, Reinoso J, Salamea JC. A Case Report: Regarding Transduodenal Sphincteroplasty. Panam J Trauma Crit Care Emerg Surg 2021; 10 (1):39-42.

DOI: 10.5005/jp-journals-10030-1316

License: CC BY-NC 4.0

Published Online: 01-04-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Introduction: Stenosing papillitis is rare. It can be primary or secondary and occurs due to the presence of stones in the common bile duct. The initial treatment of choledocholithiasis is endoscopic retrograde cholangiopancreatography (ERCP). However, when ERCP is unsuccessful, the transduodenal sphincteroplasty is an alternative strategy that obtains satisfactory results in select patients. Case description: A 27-year-old female patient presents right-upper quadrant pain associated with scleral icterus. She had choledocholithiasis and cholestasis. The ERCP performed was failed, so an open cholecystectomy with common bile duct exploration was undertaken. As the ampulla could not be cannulated, a “T” tube was placed. On a postoperative day 15, a cholangiography was performed without evidence of contrast passage into the duodenum. A re-exploration of the bile duct was undertaken 30 days after and a papillary exploration through a transduodenal approach was performed. A new cholangiography was done on postoperative day 9, at which point adequate passage of contrast into the duodenum was appreciated. Conclusion: Transduodenal sphincteroplasty is a procedure rarely performed in the era of endoscopy. Nonetheless, when these cases do come up, knowing the appropriate surgical technique is crucial to obtain satisfactory results for the patient.


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  1. Takada T. Tokyo guidelines 2018: updated Tokyo guidelines for the management of acute cholangitis/acute cholecystitis. J Hepatobiliary Pancreat Sci 2018;25(1):1–2. DOI: 10.1002/jhbp.526.
  2. Castillo Castellanos R, Sndoval Valenzuela E, González Hernández M, et al. Papilitis estenosante primaria. Salud en Tabasco [en linea] 2001;7(2):404–407. [fecha de Consulta 5 de Abril de 2021]. ISSN: 1405-2091. Disponible en: https://www.redalyc.org/articulo.oa?id=48707207.
  3. Ceppa EP, Thomas KM, Schwartz PB. Advanced biliary procedures. The SAGES manual of biliary surgery. Cham: Springer; 2020. pp. 265–285.
  4. Buxbaum JL, Abbas Fehmi SM, Sultan S, et al. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. Gastrointest Endosc 2019;89(6):1075–1105.e15. DOI: 10.1016/j.gie.2018.10.001.
  5. Scott-Conner CEH, Chassin JL. Sphincteroplasty: surgical legacy technique. In: Scott-Conner C, ed. Chassin's operative strategy in general surgery. New York: Springer; 2014. DOI: 10.1007/978-1-4614-1393-6_82.
  6. Gad EH, Zakaria H, Kamel Y, et al. Surgical (open and laparoscopic) management of large difficult CBD stones after different sessions of endoscopic failure: a retrospective cohort study. Ann Med Surg (Lond) 2019;43:52–63. DOI: 10.1016/j.amsu.2019.05.007.
  7. Peel AL, Hermon-Taylor J, Ritchie HD. Technique of transduodenal exploration of the common bile duct. Duodenoscopic appearances after biliary sphincterotomy. Ann R Coll Surg Engl 1974;55(5):236–244.
  8. Manes G, Paspatis G, Aabakken L, et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2019;51(5):472–491. DOI: 10.1055/a-0862-0346.
  9. Mesleh MG, Asbun HJ. Management of common bile duct injury. In: Asbun HJ, Shah MM, Ceppa EP, et al., ed. The SAGES manual of biliary surgery [Internet]. Cham: Springer International Publishing; 2020. [cited janvier 14, 2020] pp. 213–231. Available at: 10.1007/978-3-030-13276-7_14.
  10. Miccini M, Bonapasta S, Gregori M, et al. Indications and results for transduodenal sphincteroplasty in the era of endoscopic sphincterotomy. Am J Surg 2010;200(2):247–251. DOI: 10.1016/j.amjsurg.2009.08.048.
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