Sphincterotomy: Overview, Preparation, Procedure, Recovery, Risks, and Aftercare
Overview of Sphincterotomy
There are certain conditions that affect the bile ducts and pancreatic ducts that can be treated with sphincterotomy. An incision or cut is made in the sphincter of Oddi, a muscular valve that controls the flow of bile and pancreatic juices into the small intestine. Gallstones, bile duct stones, and pancreatic duct strictures are common conditions treated with sphincterotomy. A specialized instrument called an endoscope is typically used to perform the procedure endoscopically.
Preparation
A patient is typically evaluated by their healthcare provider before undergoing a sphincterotomy in order to determine if they are a good candidate for the procedure based on their overall health. It is possible to undergo a physical examination, blood tests, ultrasound or MRI imaging studies, or other diagnostic tests as part of this process. In order to ensure the stomach is empty, patients may be instructed to refrain from eating or drinking for a certain period before the procedure. During the procedure, certain medications, especially blood thinners, may also need to be temporarily stopped.
Procedure
For a sphincterotomy to be comfortable and relaxing, the patient is usually under sedation or anesthesia. An endoscope is a thin, flexible tube with a camera and light attached to it, inserted through the mouth and guided into the duodenum, the first part of the small intestine. On a monitor, the healthcare provider can see the pancreatic ducts and bile ducts with the endoscope. In order to remove gallstones or bile duct stones, a small incision or cut is made in the sphincter of Oddi using specialized tools passed through the endoscope.
Recovery
The sphincterotomy procedure is usually followed by a period of recovery in a recovery area once the sedation wears off. From the endoscope, some patients may experience discomfort or soreness in their throat, as well as bloating or gas. Following the procedure, patients are typically advised to avoid strenuous activities for a brief period of time, and pain medication may be prescribed to manage any discomfort. Within a day or two after the procedure, most patients are able to resume their normal activities.
Risks
Despite being generally considered safe, sphincterotomies do carry some risks and potential complications. Various complications may occur, including bleeding, infection, perforation, or injury of the bile ducts or surrounding tissues, pancreatitis (pancreatitis), and adverse reactions to anesthesia or sedation. When the procedure is performed by an experienced healthcare provider in a well-equipped medical facility, complications are relatively low.
Aftercare
To promote healing and prevent complications after a sphincterotomy, patients may be advised to follow certain dietary guidelines. The patient should stay hydrated and slowly reintroduce solid food as tolerated while avoiding fatty or spicy foods that may aggravate digestive symptoms. To monitor recovery progress and address any concerns or complications that may arise, it is necessary to attend all follow-up appointments with the healthcare provider. A successful sphincterotomy procedure usually results in relief from symptoms and improved bile flow.
