[Papillotomy or papilloplasty? Clinical and endoscopic follow-up after papillary surgery]

We controlled patients after surgical incision of the papilla for papillary stone or papillary stenosis. 131 were examined clinically, 39 of them additionally with ERCP. The endoscopy showed that simple cutting of the papilla (i.e. papillotomy) often resulted in a restenosis because of accretion of the incised duodenal mucosa. This was prevented by the additional suture of the choledochal and duodenal mucosa (i.e. papilloplasty). The clinical results, however, were equally good with both surgical techniques. This rises the question in view of the striking endoscopical results, whether the clinical examination alone is an adequate criterion to detect stasis disorders of the liver and the pancreas. The results confirm us to perform, when surgical incision of the papilla is necessary, rather a papilloplasty than a papillotomy.