CALIBRATION OF PAPILLOTOMY IN THE SURGICAL-TREATMENT OF PAPILLARY STENOSIS - THE LITTLE TRAIN

Although laparoscopic and endoscopic surgery hare brought about an ind isputable revolution in biliary surgery, many surgeons still prefer op en surgery for lithiasis of the common bile duct, and if it is associa ted with a papillary pathology, they perform a papillotomy. However, g reat controversy regarding the site, modalities, and extension of the papillary section has now developed among surgeons, Our technique is n ot original; however, we do propose a ''calibration'' of the papilloto my, carried out by constructing a ''little train'' made up of several consecutive Nelatons of increasing caliber to identify the sphincter f ibers and to obtain sections proportionate to the size of the bile duc t, Of the 115 patients in this series who were treated by open papillo tomy, only 1 developed acute pancreatitis; 2 demonstrated bleeding, 1 of whom required surgical exploration.