Oddi's Sphincter Macrodilation or Sphincteroplasty in the Treatment of the Large Bile Duct Stone

Abstract

Introduction: Oddi's sphincter macrodilation or sphincteroplasty, is a large dilation of the papilla which complements a endoscopic sphincterotomy in case of large stones. Our aim is to clarify the results and the complications of the sphincteroplasty, as well as the factors associated. Patients and methods: it’s retrospective study of January 2008 to June 2017, including 44 patients. In whom the diagnosis of large biliary lithiasis is defined by a diameter greater than 15 mm and which required a sphincteroplasty. Results: 44 patients (27 women and 17 men) of average age 63.5 years, with sex ratio men / women is 0.6. The average diameter of the bile duct was 18 ± 4 mm, that of the stones was 18 ± 2 mm and that of the dilatation balloon was 16.9 ± 4 mm. The success rate was obtained in 91% of the cases and the extraction was impossible in 4 patients with large stones of 19mm diameter. Two of these patients benefited from a plastic biliary prosthesis and the other two were treated surgically. The complication rate was 6.8% in the form of minimal bleeding corrected by pneumatic compression. Conclusion: Oddi's sphincter macrodilation or sphincteroplasty is an effective solution for extracting large biliary stone, in our study the success rate was 91% and the immediate complications were rare (6.8%).