Endoscopic sphincterotomy in the treatment of cholangiopancreatic diseases.

Abstract

AIM:

To investigate the therapeutic effect of endoscopic sphincterotomy (EST) in the treatment of choledocholithiasis and stenosing papillitis.

METHODS:

A total of 1 026 patients undergoing EST during July 1983 to May 2003 at the institute were retrospectively analyzed. Chronic pancreatitis was diagnosed in 63 (6.1%), cholecystolithiasis and choledocholithiasis in 549 (53.5%), stones in residual biliary duct in 249 (24.3%), stenosing papillitis in 228 (22.2%). In patients with simple stenosing papillitis, most incisions were within 0.5-1 cm in length. As for patients with chronic pancreatitis simultaneously, selective pancreatic sphincterotomy was performed, and incision was within 0.5-0.8 cm in length. For stones less than 1 cm, incision was from 1 to 1.5 cm, and for those larger than 1 cm, incision ranged from 1.5 to 3 cm. For stones more than 2 cm in diameter, detritus basket rather than simple incision was chosen.

RESULTS:

Of the 798 patients with choledocholithiasis, 764 (93.5%) had successful stone clearance, 215 (94.3%) out of 228 cases of stenosing papillitis were cured totally, while 63 had chronic pancreatitis developed from stenosing papillitis, 57 (90.1%) had sound remission of symptoms, though membranous stenosis emerged in 13 of 57 which was treated with balloon dilatation. After the operation, only 21 cases (2.1%) had complications such as severe pancreatitis and incision bleeding. None of the patients died.

CONCLUSION:

EST is an ideal surgical management with mini-invasion in the treatment of choledocholithiasis and stenosing papillitis.

• Authors: Zhi-Hua Li, Min Chen, Ji-Kui Liu, Jun Ding, Jia-Hong Dong
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 11 Issue 17 Pg. 2678-80 (May 07 2005) ISSN: 1007-9327 [Print] United States
• PMID: 15849834 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Ampulla of Vater (pathology, surgery)
• Cholecystolithiasis (surgery)
• Choledocholithiasis (surgery)
• Female
• Humans
• Male
• Middle Aged
• Pancreatitis (surgery)
• Postoperative Complications
• Retrospective Studies
• Sphincter of Oddi Dysfunction (pathology, surgery)
• Sphincterotomy, Endoscopic