Abstract | BACKGROUND: METHODS: A 50-year-old female with history of Roux-en-Y gastric bypass presented with episodic right-upper-quadrant and epigastric abdominal pain with associated documented elevations in liver chemistries. Preoperative cross-sectional imaging demonstrated dilation of her common bile duct. After multidisciplinary discussion, the decision was made to pursue operative transduodenal sphincteroplasty. RESULTS: All key operative steps of the transduodenal sphincteroplasty are demonstrated in the embedded video. Key operative steps include laparotomy, generous Kocher maneuver, and duodenotomy over the ampulla, allowing access for sequential biliary and pancreatic sphincterotomies and sphincteroplasties with absorbable suture. The duodenotomy and abdominal fascia are then closed. Our patient underwent sequential diet advancement and was discharged to home on postoperative day five. At clinic follow-up, pancreatobiliary-type pain had resolved. CONCLUSION: The embedded video demonstrates a case of operative transduodenal sphincteroplasty, which can provide durable results in appropriate patient populations.
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Authors | Kyle A Lewellen, Thomas K Maatman, Nicholas J Zyromski |
Journal | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
(J Gastrointest Surg)
Vol. 27
Issue 11
Pg. 2665-2666
(Nov 2023)
ISSN: 1873-4626 [Electronic] United States |
PMID | 37787871
(Publication Type: Case Reports, Video-Audio Media, Journal Article)
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Copyright | © 2023. The Society for Surgery of the Alimentary Tract. |
Topics |
- Humans
- Female
- Middle Aged
- Sphincterotomy, Transduodenal
(methods)
- Sphincter of Oddi
(surgery)
- Sphincter of Oddi Dysfunction
(diagnosis, surgery)
- Common Bile Duct
- Pain
- Ampulla of Vater
(surgery)
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