World Congress of Surgery. Lisbon (PRT), 1995/08/07.
Transduodenal sphincteroplasty is designed to destroy the sphincteric muscle fibers, producing a terminal choledochoduodenostomy.
In the absence of Oddi's sphincter, intestinal contents with both activated pancreatic juice and bacterial flora are refluxed into the bile duct and remain there for a prolonged time.
The long-term effect of producing the reflux has not been evaluated to date.
One hundred nineteen consecutive patients undergoing transduodenal sphincteroplasty between February 1973 and July 1984 were included in this study.
Postoperative clinical courses of 108 patients could be evaluated by means of a retrospective review of the hospital records.
Median follow-up was 18 years.
Eight cases (7.4%) of primary bile duct cancer were found among the 108 cases at intervals of 1 to 20 years after sphincteroplasty.
The patency of sphincteroplasty was confirmed in all cases, and the bile was injected in seven cases.
Pathologic specimens obtained demonstrated cholangiocarcinomas and various degrees of atypical hyperplastic lesions under the background of chronic cholangitis.
Chronic cholangitis can be an important causative factor in late development of bile duct cancer after sphincteroplasty.
Any patients treated with choledochoduodenostomy should be closely monitored for late cholangiocarcinoma.
Mots-clés Pascal : Sphinctérotomie, Endoscopie, Sphincter Oddi, Effet biologique, Reflux duodénobiliaire, Long terme, Carcinome, Voie biliaire, Complication, Incidence, Exploration cytologique, Pathogénie, Angiocholite, Résultat, Homme, Chirurgie, Appareil digestif pathologie, Voie biliaire pathologie, Tumeur maligne, Anatomopathologie, Bactériose, Infection
Mots-clés Pascal anglais : Sphincterotomy, Endoscopy, Oddi sphincter, Biological effect, Duodenobiliary reflux, Long term, Carcinoma, Biliary tract, Complication, Incidence, Cytologic investigation, Pathogenesis, Cholangitis, Result, Human, Surgery, Digestive diseases, Biliary tract disease, Malignant tumor, Pathology, Bacteriosis, Infection
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0299672
Code Inist : 002B25G03. Création : 15/07/1997.