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Sphincterotomy is cutting the muscle that surrounds the opening of the ducts, or the papilla.

Minor duct stenting. Click to Enlarge

Removed bile duct stones. Click to Enlarge

A sphincterotomy does not usually cause discomfort; you do not have nerve ending there. This small cut by sphincterotomy to biliary and/or pancreatic papilla allows various treatments in ducts, depending on the type of treatment you need. The most common treatment through a biliary sphincterotomy is removal of bile duct stone[s].

After a sphincterotomy is performed to enlarge the opening of the bile duct, stones can be pulled from the duct into the bowel. A variety of balloons and baskets attached to specialized catheters can be passed through the ERCP scope into the bile duct allowing these stones removal. Very large stones may require cruching in the duct with a specialized basket (mechanical biliary lithotripsy) or electrohydrolic device. Then, the biliary duct stone fragments can be pulled out through the sphincterotomy hole by Dr. Ertan under fluoroscopy guidance.