What is Endoscopic Sphincterotomy?

Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon
Endoscopy equipment.
Endoscopy equipment.

Endoscopic sphincterotomy is a minimally invasive surgical procedure where instruments and a camera for visualizing the surgical site are inserted through small incisions to allow a 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 permits drainage from the common bile duct and pancreatic duct, allowing the surgeon to see inside and to extract blockages, in addition to releasing blocked bile. This procedure is usually performed by a specialist, although a general surgeon may offer it as well.

A fiber-optic tube called an endoscope allows the surgeon to complete the surgery without creating a large incision.
A fiber-optic tube called an endoscope allows the surgeon to complete the surgery without creating a large incision.

This procedure is indicated when a patient clearly has a biliary obstruction. Symptoms of a bile duct obstruction can include nausea, abdominal pain, dark urine, and pale stools. Historically, invasive surgeries were required to identify and correct the obstruction and the risks for the patient could be high. With the development of endoscopic surgical procedures, doctors had access to a much safer surgical technique. Endoscopic sphincterotomy was used originally as a diagnostic tool, with the doctor inserting the camera through the incision in the sphincter to see what was happening inside the patient. Today, it is used in treatment of biliary obstructions.

Conscious sedation and local anesthetics may be administered before the sphincterotomy begins.
Conscious sedation and local anesthetics may be administered before the sphincterotomy begins.

When the flow of bile is interrupted by a blockage at or above the Sphincter of Oddi, endoscopic sphincterotomy can allow a surgeon to remove bile stones, a common source of blockages. This type of procedure also allows the surgeon to also address strictures, narrowings of the duct that make it harder for the patient's bile to move freely into the intestinal tract. The space is small and narrow, and the surgeon needs to be experienced with endoscopies to avoid injuring the patient during the surgery.

Symptoms of a bile duct obstruction can include nausea, abdominal pain, dark urine, and pale stools.
Symptoms of a bile duct obstruction can include nausea, abdominal pain, dark urine, and pale stools.

Risks of an endoscopic sphincterotomy can include infection, tears, or other injuries to the bile duct and neighboring tissues, and adverse reactions to the anesthetics used during the surgery. Patients can reduce their risks by fully discussing their medical histories with the surgeon and anesthesiologist before the endoscopic sphincterotomy, following aftercare directions carefully, and working with an experienced surgeon who has performed this procedure before.

An endoscopic sphincterotomy has a much shorter typical recovery time than a traditional procedure with a large incision.
An endoscopic sphincterotomy has a much shorter typical recovery time than a traditional procedure with a large incision.

After the procedure is performed, the patient should experience relief from the bile duct obstruction and will be much more comfortable. Patients with a history of bile stones are often advised to watch out for warning signs in the future, as they can recur. If bile stones become a chronic problem, other treatment options may need to be explored to address the problem.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a wiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a wiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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Discussion Comments

live2shop

We are so fortunate that endoscopic surgery was developed. Many surgeries for exploration and repair are now done easily and with less risk than when these procedures had to be performed with regular surgery that was invasive to the body.

When someone has a problem with biliary sphincterotomy, a surgeon can use endoscopic surgery. A few small cuts are needed so the surgeon can see through the camera and use small instruments to take out the biliary blockage, is a whole lot better than full fledged surgery. And the recovery time is much shorter. Hats off to the medical researchers!

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    • Endoscopy equipment.
      Endoscopy equipment.
    • A fiber-optic tube called an endoscope allows the surgeon to complete the surgery without creating a large incision.
      A fiber-optic tube called an endoscope allows the surgeon to complete the surgery without creating a large incision.
    • Conscious sedation and local anesthetics may be administered before the sphincterotomy begins.
      Conscious sedation and local anesthetics may be administered before the sphincterotomy begins.
    • Symptoms of a bile duct obstruction can include nausea, abdominal pain, dark urine, and pale stools.
      Symptoms of a bile duct obstruction can include nausea, abdominal pain, dark urine, and pale stools.
    • An endoscopic sphincterotomy has a much shorter typical recovery time than a traditional procedure with a large incision.
      An endoscopic sphincterotomy has a much shorter typical recovery time than a traditional procedure with a large incision.
    • An endoscopic sphincterotomy may cause tears to the bile duct.
      An endoscopic sphincterotomy may cause tears to the bile duct.