post sphincterotomy trouble

To Dr. Kevin and Surgeon

[Kevin Pho, MD]

Tough situation.  I'm not a surgeon, so I can't really comment on whether the surgeries proposed makes any sense.  

I can quote a variety of studies suggesting that sphincterotomy only has a 50 to 60 percent success rate in improving symptoms:

TI - Transduodenal sphincteroplasty and transampullary septectomy for postcholecystectomy pain.
AU - Moody FG; Becker JM; Potts JR
SO - Ann Surg 1983 May;197(5):627-36.

TI - Transduodenal sphincteroplasty. 5-25 year follow-up of 89 patients.
AU - Nardi GL; Michelassi F; Zannini P
SO - Ann Surg 1983 Oct;198(4):453-61.

TI - Experience with sphincteroplasty and sphincterotomy in pancreatobiliary surgery.
AU - Anderson TM; Pitt HA; Longmire WP Jr
SO - Ann Surg 1985 Apr;201(4):399-406.

TI - Microscopic transduodenal sphincteroplasty and transampullary septoplasty for papillary stenosis.
AU - Stephens RV; Burdick GE
SO - Am J Surg 1986 Dec;152(6):621-7.

TI - Results of sphincteroplasty in patients with spastic sphincter of Oddi. Predictive value of operative biliary manometry and provocation tests.
AU - Hastbacka J; Jarvinen H; Kivilaakso E; Turunen MT
SO - Scand J Gastroenterol 1986 Jun;21(5):516-20.

If you are not comfortable with any of the decisions, you can certainly consider another opinion - including the Mayo Clinic.  Unfortunately, I cannot recommend a surgeon who specializes in this area.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

Since you seem to be in or near San Francisco, I'd suggest contacting Dr. Larry Way, who is an expert in biliary surgery. He's at UCSF. He'd be an excellent resource. Here's some info:
Professor of Surgery
Director, Videoscopic Training Programs,
Department of Surgery, UCSF
Address: UCSF
513 Parnassus Avenue, S-550
Box 0475
San Francisco, CA 94143-0475
Clinical Telephone Number: 415-353-2161
New Patient Coordinator/
Referring Physician Liaison: 415-353-2804
Academic Telephone Number: 415-476-6359
E-mail: ***@****
Medical School: University of Buffalo
Residency Training: University of California, San Francisco
Licensure: California
Board Certification: American Board of Surgery, 1969