[The importance of endoscopic papillosphincterotomy in biliary tract surgery]

Based upon 129 endoscopic operations in 98 patients with choledocholithiasis and stenosis of the major duodenal papilla the authors came to a conclusion on an increasing significance of endoscopic papillosphincterotomy (EPST) in the surgery of bile ducts. EPST was shown to be followed by less amount of complications and less lethality as compared with surgical papillosphincterotomy. The intrahospital lethality after EPST was 1%. EPST allowed to elevate efficiency of the treatment in elderly and senile patients. It may be considered as an alternative surgical intervention after preceding cholecystectomy and can be used as an emergency procedure for acute obstructive purulent cholangitis and pancreatitis. In patients with little operative risk and preserved bile duct the indications for EPST must be restricted.