[Combined radiomanometric and histological studies in the surgery of Vater's ampulla]

In 34 patients a transduodenal sphincteroplasty was performed for benign stenosis of the papilla of Vater or stones in the area of the papilla. The combined intraoperative radiomanometric investigations as well as the histological examinations of intraoperative biopsis of the liver and the papilla of Vater suggest that in most cases with elevated pressure values of the common duct pathological changes of the liver with signs of cholostasis as well as of the papilla of Vater either with pathohistological alterations or with stones in this area can be detected. Constantly, histological changes of the papilla of Vater lead to pathologically elevated pressures in the common duct. In these cases transduodenal sphincteroplasty is recommended instead of only treating with a bougie or dilating the papilla. The indication for this procedure can be objectified by intraoperative radiomanometry.