Biliary endoscopic sphincterotomy

Biliary endoscopic sphincterotomy is a procedure where the sphincter of Oddi and the segment of the common bile duct where it enters the duodenum are cannulated and then cut with a sphincterotome, a device that includes a wire which cuts with an electric current (electrocautery).

This procedure was developed in both Germany and Japan and was first published in each nation in 1974. It has become a very common technique, useful for treatment of a wide variety of conditions of the biliary system such as the evacuation of gallstones within the bile duct (choledocholithiasis), biliary or papillary strictures, sphincter of Oddi dysfunction, bile leaks, and others. In addition, it is commonly performed during an endoscopic retrograde cholangiopancreatography (ERCP), and it may be used for facilitating diagnostic procedures such as transpapillary bile duct biopsy, papillary tumor biopsy, and insertion of a cholangioscope.