[Obligatory surgery after endoscopic sphincterotomy for the treatment of stones in the common bile duct].
Endoscopic sphincterotomy is the treatment of choice for stones in the common bile duct in patients with a high operative risk. However, when this modality is insufficient or fails, these patients need to be operated. The authors have operated 14 patients under these conditions. In addition to the cholecystectomy performed in 9 patients who still retained their gallbladder, the common bile duct was cleared in 3 cases and drained by means of choledochoduodenal anastomoses in 10 cases. Three patients developed complications and one of them died. Endoscopy and surgery appear to be complementary in this indication. Sphincterotomy should be proposed as first-line treatment as, even in the case of incomplete disobstruction, it enables high-risk patients to be operated under better conditions.
Ozoux
J P
JP
Service de Chirurgie Digestive et Thoracique, Hôpital Trousseau, CHU Tours.
De Calan
L
L
Berton
C
C
Favre
J P
JP
Dorval
E
E
Brizon
J
J
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002763:Cholecystectomy; D003135:Common Bile Duct / Q000601:surgery; D004386:Duodenum / Q000601:surgery; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D012086:Reoperation; D013105:Sphincterotomy, Transduodenal / Q000379:methods*
Chirurgie de nécessité après échec de la sphinctérotomie endoscopique dans le traitement des lithiases de la voie biliaire principale.