EurekaMag.com logo
+ Site Statistics
References:
53,869,633
Abstracts:
29,686,251
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Endoscopic sphincterotomy as a therapeutic measure in cholangitis and as prophylaxis against recurrent biliary tract stones



Endoscopic sphincterotomy as a therapeutic measure in cholangitis and as prophylaxis against recurrent biliary tract stones



Endoscopy 19(1): 14-16



Our purpose was to analyse the results of endoscopic sphincterotomy in patients with advanced cholangitis, and to assess the potential of this method in the prevention of recurrent biliary tract stones. Advanced cholangitis certainly predisposes to microlith formation, and we believe that the increased biliary drainage produced by sphincterotomy counteracts this process. Our grading of cholangitis was an intraoperative cholangioscopic assessment corresponding to Nishimura grades III and IV (erosions in the duct walls, patchy stone ulceration, biliary gravel, fibro-purulent plaques densely adherent to the biliary walls etc.). 62 patients with grades III and IV cholangitis (as defined at choledochoscopy) underwent endoscopic sphincterotomy (GP-A). This group underwent a controlled prospective study with review at: (1) one year, (2) between 2 and 3 years, (3) 5 years following surgery. The control group (GP-B) constituted 20 patients with comparable cholangitis who did not undergo sphincterotomy. Group A had no recurrent lithiasis, 4.8% revealed persistent cholangitis. In control group (GP-B) 6 patients (30%) revealed recurrent lithiasis, on average 4.6 years following initial surgery. In addition, 35% of this group had clinical symptoms of cholangitis. These results indicate that endoscopic sphincterotomy is a worthwhile method in the treatment of cholangitis and prophylaxis against recurrent biliary tract stones.

(PDF emailed within 0-6 h: $19.90)

Accession: 005359601

Download citation: RISBibTeXText

PMID: 3830087

DOI: 10.1055/s-2007-1018218



Related references

Endoscopic sphincterotomy as a therapeutic measure in cholangitis and as a prophylaxis against recurrent biliary tract stones. Digestive Surgery 3(2): 131, 1986

Gallbladder function and recurrent stones of the biliary tract in patients after endoscopic sphincterotomy. Scandinavian Journal of Gastroenterology 31(6): 612-615, 1996

Endoscopic sphincterotomy and biliary drainage in patients with cholangitis due to common bile duct stones. American Journal of Gastroenterology 90(2): 233-238, 1995

Biliary motility following endoscopic sphincterotomy for recurrent common bile duct stones. Zhonghua Yi Xue Za Zhi 56(3): 159-165, 1995

Endoscopic sphincterotomy long term results of the treatment of recurrent missed biliary stones. Digestive Surgery: 148-149, 1986

Does prophylactic endoscopic sphincterotomy prevent recurrent biliary problems in patients with gallstones, suspected common bile duct stones and a normal cholangiogram?. Gut 46(11): A63, April, 2000

Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metaanalysis of randomized, controlled trials. American Journal of Gastroenterology 99(8): 1455-1460, 2004

The role of endoscopic biliary sphincterotomy for the treatment of type 1 biliary dysfunction (papillary stenosis) with or without biliary stones. American Journal of Surgery 207(1): 65-69, 2014

Biliary manometry is a low yield investigation in patients with recurrent biliary pain after endoscopic biliary sphincterotomy , but recurrent pancreatitis in this population may reflect previously undiagnosed pancreatic sphincter hypertension. Digestive Disease Week Abstracts & Itinerary Planner : Abstract No T1556, 2003

Acute suppurative obstructive cholangitis due to stones treatment by urgent endoscopic sphincterotomy. Gastrointestinal Endoscopy 33(3): 210-213, 1987

Initial duodenoscopic sphincterotomy in patients with acute cholangitis or pancreatitis complicating biliary stones. Gastroenterology 82(5 PART 2): 1042, 1982

Endoscopic sphincterotomy and biliary stones. Annales de Gastroenterologie et d'Hepatologie 22(5): 283-286, 1986

Reflux of duodenal contents and cholangitis after endoscopic biliary sphincterotomy. Gastrointestinal Endoscopy 72(1): 225; Author Reply 226-225; Author Reply 226, 2010

Cholangitis after endoscopic sphincterotomy in patients with stricture of the biliary duct. Surgery, Gynecology & Obstetrics 163(4): 324-326, 1986

A randomised controlled trial of endoscopic sphincterotomy in acute cholangitis without common bile duct stones. Gut 51(2): 245-247, 2002