Endoscopic Sphincterotomy

Updated: Dec 03, 2015
  • Author: Priya A Jamidar, MD, FACG, FASGE; Chief Editor: Kurt E Roberts, MD  more...
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Overview

Background

Endoscopic biliary sphincterotomy was first reported in 1974. Approximately 150,000 patients undergo endoscopic biliary sphincterotomy in the United States each year. Sphincterotomy is a complex procedure that incorporates the use of endoscopic as well as fluoroscopic guidance. The technique involves deep cannulation of the bile duct followed by severance of the sphincter of Oddi with the electrocautery. This topic focuses on preparation for, as well as the technique involved in, endoscopic biliary sphincterotomy.

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Indications

The primary indications for endoscopic sphincterotomy include extraction of common bile duct stones, treatment of papillary stenosis, and facilitation of endotherapy (ie, stent placement, tissue sampling, and stricture dilation).

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Contraindications

Recent myocardial infarction, severe cardiopulmonary disease, recent attack of acute pancreatitis, and contrast dye exposure causing anaphylaxis are contraindications.

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