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Endoscopic sphincterotomy without cholecystectomy for gall stone pancreatitis
C R Welbourn1, D E Beckly, I A Eyre-Brook
1Department of Surgery, Musgrove Park Hospital, Taunton.
Gut
|July 1, 1995
Summary
Endoscopic sphincterotomy alone effectively prevents gallstone pancreatitis recurrence in elderly patients. This minimally invasive procedure offers a safe alternative to gallbladder removal, reducing acute pancreatitis attacks.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Pancreatology
Background:
- Gallstone pancreatitis is a common complication of gallstones.
- Cholecystectomy is the standard treatment, but carries risks, especially in the elderly.
- Endoscopic sphincterotomy (EST) is an alternative for stone removal.
Purpose of the Study:
- To evaluate the effectiveness of EST alone in preventing recurrent acute pancreatitis.
- To assess the long-term outcomes of EST in elderly patients with gallstone pancreatitis.
Main Methods:
- Retrospective follow-up of 51 elderly patients (median age 78) who underwent EST for gallstone pancreatitis.
- Patients did not have a planned cholecystectomy.
- Follow-up duration averaged 26.9 months.
Main Results:
- Technical success of EST in 48 patients (94%).
- No recurrent acute pancreatitis in patients with successful EST.
- Two of three patients (67%) with incomplete EST experienced recurrent pancreatitis.
Conclusions:
- Endoscopic sphincterotomy alone is a safe and effective treatment for preventing recurrent gallstone pancreatitis in the elderly.
- EST offers a viable alternative to cholecystectomy in this patient population.
- Successful EST is crucial for preventing pancreatitis recurrence.
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