[Retained cholelithiasis--a risk factor after endoscopic papillotomy?]

Endoscopic papillotomy (EPT) today is in well defined indications an accepted procedure for the therapy of common bile duct stones. In patients with stone gallbladder in situ and bile duct stones it has been recommended to remove the gallbladder after papillotomy in order to prevent late complications. The present study shows that the gallbladder in situ is not necessarily a significant risk factor. On an average of 34,9 months (16-84) after EPT of 223 patients with a follow up, 83,7% were free of symptoms or significantly improved. Cholecystectomy was performed in 43 patients (18,9%): in 24 (11,6%) within an interval , in 13 (6,3%) as an emergency operation following a complication of EPT and in 2 (1%) months later because of recurrent cholecystitis. In patients over 70 years of age with increased risk for surgery therefore a gallbladder with stones after EPT must not absolutely be removed. A wait and see attitude may be justified.