Semicircular papillotomy: a new surgical technique for removal of bile stones lodged in the ampulla of Vater.

Bile stones lodged in the ampulla of Vater present a rare but often difficult problem. Considering the disadvantages of conventional papillotomy and papillectomy, we developed a technique in which both the anatomic structures and their function are preserved. Histologic studies of the ampulla provided the basis for the technique, in which the muscular layers of the ampulla are not cut through as in conventional papillotomy but are bluntly separated, preserving this important anatomic component of the ampulla saved. The postoperative and long-term outcome of seven patients with bile stones lodged in the ampulla are reported. We found semicircular lateral papillotomy a safe procedure that preserves the muscular structures and function of the ampulla.