[Intra-operative identification of the ostium of Wirsung's pancreatic duct after papillosphincterotomy]. / Identificação trans-operatória do óstio do Wirsung após a papilo-esfincterotomia.

PURPOSE: The aim of this study is to suggest a feasible method to find the ostium of the Wirsung's duct during sphincteroplasty of the Vater's papilla, in order to avoid post-operative complications such as acute pancreatitis. PATIENTS AND METHODS: A total of 27 patients were submitted to sphincteroplasty for choledocolithiasis with or without Odditis. After therapeutic papillotomy and sphincterotomy through the duodenun, the location of the ostium of the Wirsung's duct was determined and studied. After papillotomy, the Vater's papilla becomes an isosceles triangle and its measurements were made with a compass. Thereby the ostium of Wirsung's duct was easily detected and a catheter was inserted before the suture of the mucosa of the papilla. RESULTS: The ostium was generally found medially, on the left side of the triangle, 0.19 cm to 0.25 cm on average above its base whether there was inflammation or not, respectively. CONCLUSION: The transoperative determination of the dimensions as proposed in this study, allows a safety detection and cannulation of the Wirsung's duct with or without inflammation of the Oddi's sphincter.