Advanced Biliary Procedures

  • Eugene P. CeppaEmail author
  • Thomas K. Maatman
  • Patrick B. Schwartz


The comprehensive management of gallbladder disease includes not only understanding the principles of safe cholecystectomy, intraoperative cholangiography, and bile duct exploration but also the familiarity of the current endoscopic and surgical therapies for the known associated morbidities and special scenarios. In this chapter, we will review several advanced biliary procedures including both endoscopic and minimally invasive surgical bilioenteric anastomoses as well as transduodenal sphincteroplasty with contemporary approaches, indications, technical description, and existing supportive evidence.


Biliary bypass Hepaticojejunostomy Endoscopic biliary decompression Sphincteroplasty 


  1. 1.
    Duca S. Sphincteroplasty in the treatment of biliary tract disease. A prospective study of 46 cases. Langenbecks Arch Chir. 1984;362(1):25–31.CrossRefGoogle Scholar
  2. 2.
    Partington PF. Twenty-three years of experience with sphincterotomy and sphincteroplasty for stenosis of the sphincter of Oddi. Surg Gynecol Obstet. 1977;145:61–168.Google Scholar
  3. 3.
    Nakeeb A. Sphincter of Oddi dysfunction: how is it diagnosed? How is it classified? How do we treat it medically, endoscopically, and surgically? J Gastrointest Surg. 2013;17(9):1557–8.CrossRefGoogle Scholar
  4. 4.
    Shah KN, Clary BM. Stones in the bile duct: clinical features and open surgical approaches and techniques. In: Jarnagin W, editor. Blumgart’s surgery of the liver, biliary tract, and pancreas. 6th ed. Philadelphia: Elsevier; 2017. p. 585–603.Google Scholar
  5. 5.
    Makary MA, Elariny HA. Laparoscopic transduodenal sphincteroplasty. J Lap Adv Surg Tech. 2006;16(6):629–32.CrossRefGoogle Scholar
  6. 6.
    Jones SA, Smith LL. Transduodenal sphincteroplasty for recurrent pancreatitis; a preliminary report. Ann Surg. 1952;136(6):937–47.CrossRefGoogle Scholar
  7. 7.
    Kourias BG, Tierris EJ. Transduodenal sphincterotomy with strict indications. An evaluation of 113 cases. Am J Surg. 1966;112(3):426–31.CrossRefGoogle Scholar
  8. 8.
    Jones SA, et al. Transduodenal sphincteroplasty (not sphincterotomy) for biliary and pancreatic disease. Indications, contraindications, and results. Am J Surg. 1969;118(2):292–306.CrossRefGoogle Scholar
  9. 9.
    Negro P, et al. Surgical risk of the Oddi sphincterotomy. Results of an international survey (25541 cases). J Chir. 1984;121(2):133–9.Google Scholar
  10. 10.
    Wiersema MJ, et al. Endosonography-guided cholangiopancreatograph. Gastrointest Endosc. 1996;43(2):102–6.CrossRefGoogle Scholar
  11. 11.
    Carboni M, et al. Transduodenal sphincterotomy in laparoscopic era. World J Surg. 2001;25(10):1357–9.CrossRefGoogle Scholar
  12. 12.
    Giovannini M, et al. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage. Endoscopy. 2001;33(10):898–900.CrossRefGoogle Scholar
  13. 13.
    Novellino L, et al. Laparoscopic transduodenal papillosphincteroplasty. Surg Endosc. 2003;17(11):1849.PubMedGoogle Scholar
  14. 14.
    Chowbey PK, et al. Laparoscopic hepaticojejunostomy for biliary strictures. The experience of 10 patients. Surg Endosc. 2005;19:273–9.CrossRefGoogle Scholar
  15. 15.
    Madura JA, et al. Surgical sphincteroplasty in 446 patients. Arch Surg. 2005;140(5):504–11.CrossRefGoogle Scholar
  16. 16.
    Morgan KA, et al. Transduodenal sphincteroplasty in the management of sphincter of Oddi dysfunction and pancreas divisum in the modern era. J Am Coll Surg. 2008;206(5):908–14.CrossRefGoogle Scholar
  17. 17.
    Morgan KA, et al. Sphincter of Oddi dysfunction after Roux-en-Y gastric bypass. Surgery for obesity and related diseases. SOARD. 2009;5(5):571–5.Google Scholar
  18. 18.
    Weber A, et al. Complications of percutaneous transhepatic biliary drainage in patients with dilated and nondilated intrahepatic bile ducts. Eur J Radiol. 2009;72(3):412–7.CrossRefGoogle Scholar
  19. 19.
    Roberts KJ, et al. Long-term symptomatic relief following surgical sphincteroplasty for sphincter of Oddi dysfunction. Dig Surg. 2011;28(4):304–8.CrossRefGoogle Scholar
  20. 20.
    Toumi Z, et al. Role of laparoscopic approach to biliary bypass for benign and malignant disease: a systematic review. Surg Endsoc. 2011;25:2105–16.CrossRefGoogle Scholar
  21. 21.
    Artifon E, et al. Biliary drainage in patients with unresectable, malignant obstruction where ERCP fails: endoscopic ultrasonography-guided choledochoduodenostomy versus percutaneous drainage. J Clin Gastroenterol. 2012;46(9):768–74.CrossRefGoogle Scholar
  22. 22.
    McKay A, et al. Short- and long-term outcomes following percutaneous cholecystostomy for acute cholecystitis in high-risk patients. Surg Endosc. 2012;26(5):1343–51.CrossRefGoogle Scholar
  23. 23.
    Nennstiel S, et al. Drainage-related complications in percutaneous transhepatic biliary drainage: an analysis over 10 years. J Clin Gastroenterol. 2015;49(9):764–70.CrossRefGoogle Scholar
  24. 24.
    Cotton PB, et al. Rome IV. Gallbladder and sphincter of Oddi disorders. Gastroenterology. 2016.Google Scholar
  25. 25.
    Sharaiha RZ, et al. Efficacy and safety of EUS-guided biliary drainage in comparison with percutaneous biliary drainage when ERCP fails: a systematic review and meta-analysis. Gastrointest Endosc. 2017;85(5):904–14.CrossRefGoogle Scholar
  26. 26.
    Baars J, et al. EUS-guided biliary drainage: a comprehensive review of the literature. Endosc Ultra. 2018;7(1):4–9.CrossRefGoogle Scholar
  27. 27.
    Uemura RS, et al. EUS-guided choledochoduodenostomy versus hepaticogastrostomy: a systematic review and meta-analysis. J Clin Gastroenterol. 2018;52(2):123–30.PubMedGoogle Scholar

Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2020

Authors and Affiliations

  • Eugene P. Ceppa
    • 1
    Email author
  • Thomas K. Maatman
    • 1
  • Patrick B. Schwartz
    • 2
  1. 1.Department of SurgeryIndiana University School of MedicineIndianapolisUSA
  2. 2.Department of SurgeryUniversity of Wisconsin School of MedicineMadisonUSA

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