Transduodenal sphincteroplasty for biliary tract disease.

Transduodenal sphincteroplasty is an efficient and easy method for dealing with benign biliary tract disease. With it a permanent wide-open stoma is created between the common bile duct and the duodenum, which is established only by complete division of the muscular sphinteric mechanism. Specific indications for sphincteroplasty include multiple common duct stones or "sludge", primary biliary calculi, unremovable intrahepatic stones, impacted ampullary stones, or stenosis of the sphincter of Oddi. Conditions unrelieved by sphincteroplasty include biliary dyskinesia "post-cholecystectomy syndrome", and relapsing pancreatitis with biliary disease. Sixty-five patients are presented who underwent transduodenal sphincteroplasty for benign biliary tract disease in various categories. Satisfactory results were obtained in 53 patients. Coincident pancreatic disease was associated with the least satisfactory results.