[Oddi's sphincterotomy or sphincteroplasty. Considerations on the results obtained with a personal sphincteroplasty...

A total of 21 cases are presented, of patients in whom Oddian sphincteroplasty was performed, according to an original technique. In 19 cases the indication was due to Oddian stenosis associated to lithiasis or hepatic hydatic cysts which had ruptured in the biliary pathways. In two other cases security sphincteroplasty of the Oddi sphincter was performed for lithiasis of the choledocus. The decision was based on macroscopic changes of the biliary pathways, on the control of the main biliary pathway. Sphincteroplasty was achieved with the aid of an original probe, and the incision of the ampullary area was in the average 25 mm in length. The postoperative control, made by tube cholangiography and barium examination, has evidenced the presence of a wide, open choledocoduodenal orifice. Duodenal fistula was one of the complications which followed duodenostomy. This however was fully repaired in 14 days after conservative treatment. After a confrontation of the results achieved with this method, and the data published in the literature the authors support oddian sphincteroplasty, and stress its advantages by comparison with the results provided by sphincterotomy.