[Surgical and endoscopic papillosphincterotomy in surgery of the bile ducts]

Surgical transduodenal papillosphincterotomy (TPS) on 119 patients was compared with endoscopic papillosphincterotomy (EPS) on 507 patients for rate of success and directly related complications. No major differences were found to exist between both approaches with regard to frequency or pathologico-anatomic nature of complications. Satisfactory experience has been obtained by the authors primarily from EPS on patients in advanced age or high-risk patients with choledocholithiasis following cholecystectomy (n = 320), benign and malignant stenosis of Vater's papilla (n = 97), and choledocholithiasis with gall-bladder in situ (n = 94). Intervention endoscopy of bile ducts is preferred primarily for patients in advanced age or for high-risk patients.