[Results of 108 endoscopic papillotomies]

At the Medical Clinic of the St. Elisabeth Krankenhaus, Cologne, 108 endoscopic papillotomies (EPT) were carried out between September 1977 and May 1983; 90% have been successful. Choledocholithiasis in 91 patents (84,2%) was the most frequent indication. Approximately half of the cases had had previous cholecystectomy; in the other half the still existing gall-bladder contained stones. These latter patients were definite risk-patients; their average age was 16 years above that of patients with previous cholecystectomy. Other indications have been the inflammatory (14 patients) or tumorous stenosis (3 patients) of the papilla. Complications occurred with 8 patients (7,4%); mortality-rate: 1,9%. The good results and the low rate of complications make EPT the method of choice in case of residual or recurring stones after cholecystectomy as well as in case of risk patients with existing gall-bladder and stones in the common bile duct. Further indications have been: malignant or benign papillary stenosis and acute emergency situations (acute biliary pancreatitis or cholangitis through a stone blocking the duct). The nasobiliary permanent probe, the possibility of direct litholysis, the dilatation by catheter and prolonged draining of stenosis open new applications.