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Endoscopic sphincterotomy is a minimally invasive surgical procedure used to correct a problem with the common bile duct. It involves making an incision in the Sphincter of Oddi to extract blockages and release blocked bile. The procedure is used to treat biliary obstructions, including gallstones and strictures. Risks include infection, injury to the bile duct, and adverse reactions to anesthesia. After the procedure, patients should experience relief from the obstruction.
Endoscopic sphincterotomy is a minimally invasive surgical procedure in which instruments and a camera are inserted to view the surgical site through small incisions to allow the surgeon to correct a problem with the common bile duct. During the procedure, an incision is made in the Sphincter of Oddi, a structure that allows drainage from the common bile duct and pancreatic duct, allowing the surgeon to see inside and extract blockages, as well as release blocked bile. This procedure is usually performed by a specialist, although it may also be offered by a general surgeon.
This procedure is indicated when a patient clearly has a biliary obstruction. Symptoms of a bile duct blockage can include nausea, abdominal pain, dark urine, and pale stools. Historically, invasive surgeries were required to identify and correct the obstruction, and the risks to the patient could be high. With the development of endoscopic surgical procedures, doctors have gained access to a much safer surgical technique. Endoscopic sphincterotomy was originally used as a diagnostic tool, with the doctor inserting the camera through the incision into the sphincter to see what was going on inside the patient. Today it is used in the treatment of biliary obstructions.
When the flow of bile is interrupted by a blockage at or above the sphincter of Oddi, endoscopic sphincterotomy can allow the surgeon to remove gallstones, a common source of blockages. This type of procedure also allows the surgeon to also address strictures, narrowings of the duct that make it more difficult for the patient’s bile to move freely in the intestinal tract. The space is small and narrow, and the surgeon must be experienced with endoscopy to avoid injuring the patient during the procedure.
The risks of an endoscopic sphincterotomy can include infection, tears or other injury to the bile duct and nearby tissues, and adverse reactions to the anesthetics used during the surgery. Patients can reduce their risks by thoroughly discussing their medical history with the surgeon and anesthesiologist before endoscopic sphincterotomy, carefully following aftercare directions, and working with an experienced surgeon who has previously performed this procedure.
After the procedure has been performed, the patient should experience relief from the bile duct obstruction and will be much more comfortable. Patients with a history of gallstones are often advised to pay attention to warning signs in the future, as they may recur. If gallstones become a chronic problem, you may need to explore other treatment options to address the problem.
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