Abstract | BACKGROUND/AIMS:
Endoscopic papillotomy is a well-established procedure for treating choledocholithiasis. The aim of this study is to expose our experience with this method in a prospectively collected series of 386 patients and to analyze the safety and efficacy of the pre-cut procedure. METHODOLOGY: Between October 1995 and December 1999, 760 endoscopic retrograde cholangiopancreatographies were performed in 670 patients. Of these, 449 were done to treat 386 patients with choledocholithiasis. The pre-cut technique was performed after failure of multiple cannulation attempts. RESULTS: Bile duct clearance was achieved in 344 (89.1%) cases, however the success rate would increase to 95.1%, if the cases, which endoscopic stone extraction was not feasible, were excluded. Pre-cut was performed in 31 (8.03%) patients, and 11 of them presented some procedure-related complication, while the complication rate of standard sphincterotomy was 3.9% (relative risk = 8.4; 95% confidence interval = 4.2-16.7). Overall complication rate was 6.7% (26 out of 386)-- pancreatitis = 13, bleeding = 9, acute cholecystitis = 2, cholangitis = 1, guide-wire-related choledochal perforation = 1. Thirty-day mortality was 1.55% (n = 6), but procedure-related mortality was 0.25% (n = 1). CONCLUSIONS:
Endoscopic papillotomy is a safe and effective procedure for patients with symptomatic choledocholithiasis. The pre-cut procedure increases the complication rate of the endoscopic approach, and should be restricted to cases, in which an endoscopic intervention is mandatory.
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Authors | J C Pereira-Lima, C B Rynkowski, E L Rhoden |
Journal | Hepato-gastroenterology
(Hepatogastroenterology)
2001 Sep-Oct
Vol. 48
Issue 41
Pg. 1271-4
ISSN: 0172-6390 [Print] Greece |
PMID | 11677944
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Female
- Gallstones
(mortality, surgery)
- Humans
- Intraoperative Complications
(etiology, mortality)
- Laparoscopy
- Male
- Middle Aged
- Postoperative Complications
(etiology, mortality)
- Prospective Studies
- Sphincterotomy, Endoscopic
- Survival Rate
- Treatment Outcome
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