title: Endoscopic papillotomy.
abstract: Endoscopic papillotomy is nine years old. During this time it obtained a well defined place in the treatment of common bile duct stones and of papillary stenosis. In about 85% this method proved to be successful without any problems. To lower the risk and to improve the results now smaller steps must be done. Within the last 4 years we have learned to manage even big stones with a reduced risk by stone dissolution and by a new lithotripsy device. Biliary pancreatitis has become an indication for an early duodenoscopy and even papillotomy. Acute obstructive suppurative cholangitis may be treated by endoscopy with a lower risk than by surgical intervention. Even the feared Dormia basket impaction in most cases is no longer an indication for an emergency operation. Mostly it can be treated by a second endoscope together with a new cutting device designed by Mr. Mori. All these small steps have improved the success rate of papillotomy from 94% to 99%, rate of definite stone management from 87% to 92%, reducing the complication rate from 8% to 4% at the same time.
mesh_terms: D000368:Aged; D014670:Ampulla of Vater; D002761:Cholangitis / Q000628:therapy; D003137:Common Bile Duct Diseases / Q000628:therapy; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D007440:Intubation / Q000295:instrumentation; D010195:Pancreatitis / Q000628:therapy