Sphincteroplasty

A muscular sphincter that surrounds the duct (just before it drains into the intestines) can block off the pancreatic duct. At ERCP, it is possible to measure the pressures in this sphincter and if they are high and causing problems, then the sphincter can be cut with an endoscopy knife. After cutting the muscular sphincter, scarring may develop in the substance of the pancreas and block off the pancreatic duct at a later time. This type of scar can't be cut or opened up with an endoscope and surgery may be necessary. If the pancreatic duct is dilated, then the problem can be fixed with a Puestow procedure. If the pancreatic duct does not become dilated, then a Whipple procedure can be successfully used in treating this problem.

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