[Causes of death following endoscopic papillotomy]

The results of autopsy carried out in 14 patients who died after undergoing papillotomy show that apart from non-method-related sepsis (4 cases) developing from a cholangitis in underlying choledocholithiasis, haemorrhage from the papillotomy wound is the most dangerous complication of this intervention. In one case the cause of bleeding was the severance of the retroduodenal artery, while in 3 cases bleeding occurred after a repapillotomy. In these patients the source of bleeding was a highly vascular granulation tissue in the early healing phase after the first papillotomy. In view of this danger, the primary papillotomy should as far as possible be a complete one, or else, no repapillotomy should be performed in the proliferation phase of wound healing.