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[Long term results after endoscopic sphincterotomy]
Deutsche Medizinische Wochenschrift (1946)
|April 23, 1982
Summary
Endoscopic sphincterotomy effectively treats bile duct stones, with over 90% success. However, complications like bleeding and pancreatitis occur in 7.55%, and outcomes are poorer for papillary stenosis.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Endoscopic Procedures
Context:
- Endoscopic sphincterotomy (ES) is a key procedure for managing biliary tract diseases.
- Choledochal stones are the primary indication for ES, but papillary stenosis and tumors also necessitate the intervention.
- The study analyzes data from 9041 ES procedures across 25 centers.
Purpose:
- To evaluate the indications, complications, mortality, and long-term outcomes of endoscopic sphincterotomy.
- To compare the results of ES for choledocholithiasis versus papillary stenosis.
- To assess the efficacy and safety of ES as an emergency measure.
Summary:
- Choledochal stones (83.9%) are the main indication for ES, followed by papillary stenosis (10.64%) and tumors (2.06%).
- Complications occur in 7.55% of cases, with hemorrhage being most frequent, followed by pancreatitis, cholangitis, and perforation. Mortality is 1.12%.
- Long-term success is high (91.62% stone-free), but outcomes are less favorable for papillary stenosis, with higher mortality and perforation risk.
Impact:
- Endoscopic sphincterotomy demonstrates high efficacy in clearing bile duct stones and improving patient symptoms.
- Understanding complication rates and risk factors aids in patient selection and procedural planning.
- The findings support the continued use of ES, including as an emergency intervention, while highlighting areas for improved outcomes in specific patient groups.