Abstract
A 91-case experience with immediate transduodenal sphincteroplasty in the management of acute biliary pancreatitis was reviewed. Diagnosis was made by clinical evidence of acute pancreatitis, absence of alcohol abuse, and past or present symptoms suggestive of biliary tract disease and/or gallstones. Operation was performed within 72 h of admission and revealed concomitant acute cholecystitis in 31 (34%) of the patients. Operative cholangiography (87 patients) demonstrated an obstruction to the flow of dye into the duodenum but once, while the pancreatic duct was visualized in only 3 patients. Stones were found in the gallbladder of all patients, in the common bile duct of 52 (57%), and/or in the duodenum of 21 (23%).Signs of acute pancreatitis rapidly abated following operation in all cases. There was 1 death (mortality rate 1 %) due to pulmonary embolism. No patient has experienced a recurrent attack of pancreatitis. Such data appear to affirm the practicality, safety, and reliability of immediate transduodenal sphincteroplasty for the management of acute biliary pancreatitis.
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