ENDOSCOPIC MANAGEMENT OF CHOLEDOCHOLITHIASIS AND PAPILLARY STENOSIS

Abstract

Endoscopic papillotomy was performed in 50 of 53 patients; 31 were female, with an age range of 29-87 yr, a mean of 63.1. The indications for the procedure included retained or recurrent choledocholithiasis, primary choledocholithiasis and papillary stenosis, which were responsible for persistent or intermittent cholestasis. The procedure was successful in all but 3 patients in whom the primary diagnosis was papillary stenosis. The major complications were bleeding in 3 patients, pancreatitis in 1 patient and an infected pseudocyst in 1 patient. Surgical intervention was not required and there were no deaths. Endoscopic papillotomy has proved to be safe, producing a permanent biliary enteric fistula, thus reducing the probability of formation of recurrent stones. It reduces hospitalization and convalescence, permitting an earlier return to normal activity.