Sphincterotomy: What It Is and What to Expect
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Sphincterotomy?
A gastroenterologist, a doctor who treats the digestive system, may perform a sphincterotomy. A surgeon can also perform it. It is a small cut made through an endoscope to enlarge the opening of the common bile duct. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
A sphincterotomy is a small cut that enlarges the opening of the common bile duct into the duodenum. The duodenum is the part of the small intestine that is closest to the stomach. The sphincter is a circular muscle that allows bile and pancreatic juices to flow into the intestine.
ERCP is short for endoscopic retrograde cholangiopancreatography. ERCP may be used to open the entry of the ducts into the bowel, which is called a sphincterotomy. An endoscope is a tube with a small camera.
Why a doctor might recommend it
If gallstones are present in the common bile duct, a surgeon can perform a sphincterotomy. The stones can then pass through. Some people have belly pain again after gallbladder removal, and often the cause is not clearly known. One suspected cause is sphincter of Oddi dysfunction (SOD). To treat SOD, people typically undergo a sphincterotomy. NIDDK says the suggested benefits of sphincterotomy for SOD are controversial. It also says sphincterotomy carries a substantial risk of significant complications, including pancreatitis or perforation of the bowel wall.
How to prepare
Common preparation steps include the following.
- Do not eat or drink for at least 4 hours before the test.
- Tell your provider about allergies to iodine or reactions to x-ray dyes.
- Arrange a ride home after the procedure.
What happens during it
An intravenous (IV) line is placed in your arm. Medicines to relax or sedate you are given through the IV.
The endoscope is inserted through the mouth. It goes through the esophagus (food pipe) and stomach until it reaches the duodenum. A thin tube called a catheter is passed through the endoscope into narrow tubes called ducts. A special dye is injected into these ducts, and x-rays are taken. You should not feel discomfort, and may have little memory of the test.
Recovery
Here is what to expect after ERCP, the procedure in which a sphincterotomy is done.
Air used during ERCP can cause some bloating or gas for about 24 hours. You may have a sore throat on the first day. Soreness may last for up to 3 to 4 days. Do only light activity on the first day after the procedure. Avoid heavy lifting for the first 48 hours.
Contact your provider if you have any of the following.
- Abdominal pain or severe bloating.
- Bleeding from the rectum or black stools.
- A fever above 100 degrees Fahrenheit (37.8 degrees Celsius).
- Nausea or vomiting.
Call 911 or go to the emergency room if you have trouble breathing, chest pain or discomfort lasting two minutes or more, fainting, coughing up or vomiting blood, or bleeding that will not stop.
Risks and side effects
The risks of the procedure include the following.
- A reaction to the anesthesia, dye, or medicine used during the procedure.
- Bleeding.
- A hole, called a perforation, of the bowel.
- Inflammation of the pancreas, called pancreatitis, which can be very serious.
Who performs it
A surgeon can perform a sphincterotomy.
Common questions
Is a sphincterotomy the same as ERCP?
No, a sphincterotomy is one of the things ERCP may be used for. ERCP may also be used to remove or crush gallstones.
Does a sphincterotomy help with pain after gallbladder removal?
It does not appear to help pain thought to come from SOD, says a 2014 NIDDK update. The same update says the procedure carries considerable risk.
Can a sphincterotomy cause pancreatitis?
Yes, pancreatitis, which is inflammation of the pancreas, is one of the significant complications that can follow it. Pancreatitis can be very serious.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
Sources
- MedlinePlus - ERCP
- MedlinePlus - Endoscopic retrograde cholangio pancreatography (ERCP) - series, Procedure, part 2
- National Institute of Diabetes and Digestive and Kidney Diseases - Frequently Used Endoscopic Procedure Fails To Reduce Abdominal Pain
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
