[Benign obstruction of the common bile duct: what is the current role of transduodenal sphincteroplasty?].

This paper is a critical review of the clinical records of 20 patients who underwent a Transduodenal Sphincteroplasty (PSP), from October 1990 to January 1992 at our Department (General Surgery). The age was 64.9 (14.2) years (mean and standard deviation), but 14 (70%) of those patients were older than 60 (range: 63 to 89) and 9 (45%) were in the 8th up to 9th decade of their lives. In 16 patients PSP was performed at the same time as cholecystectomy. Common bile duct (CBD) exploration was decided in 11 patients only on the basis of the intraoperative cholangiographic findings (evidence of CBD stones and/or benign stenosis of the Papilla of Vater) as demonstration of the permanent role of this examination in biliary surgery. Among the patients who underwent PSP some time after cholecystectomy, one had a lesion of the choledochus, sustained when he was cholecystectomized 15 days before. Because of the fact that recovery was prompt and definitely uneventful, PSP together with the infusion of somatostatin (SMTN) can be considered a useful approach to the treatment of the biliary fistula.