Duodenoscopic sphincterotomy and gallstone removal.
Duodenoscopic sphincterotomy was attempted in 265 patients. The procedure was successful in 243 patients (92%). Indications for sphincterotomy were: 185 patients with choledocholithiasis, 52 patients with papillary stenosis, and 6 patients with ampullary carcinoma. The clinical and biochemical evidence of cholestasis resolved in 222 of the 243 successful patients (91%). Complications consisting of hemorrhage, perforation, pancreatitis, cholangitis, and instrumental injury resulted in three deaths, an over-all mortality of 1.2%. Emergency laparotomy was required in 6 cases (2.5%). Duodenoscopic sphincterotomy is a relatively safe and effective means of relieving certain instances of extrahepatic cholestasis. The complication and mortality rates appear lower than those with equivalent conventional surgical techniques.
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D002769:Cholelithiasis / Q000601:surgery*; D004386:Duodenum; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D009803:Sphincter of Oddi / Q000601:surgery*