Endoscopic sphincterotomy: The whole truth

Lambert, Mark E.; Betts, Chris; Hill, James H.; Faragher, E. B.; Martin, D. F.; Tweedle, D. E. F.

doi:10.1002/bjs.1800780427

Cited by 123 publications

(44 citation statements)

References 29 publications

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“…Its success rate exceeds 90%, and it has been accepted as the best nonsurgical treatment for common bile duct stones [29][30][31][32][33] . However, EST is still associated with an 8%-12% rate of acute complications, such as bleeding, perforation, cholangitis, and post-procedure pancreatitis [11,25,[34][35][36][37] .…”

Section: Discussionmentioning

confidence: 99%

Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy

Kim¹,

Cheon²,

Cho³

et al. 2009

WJG

101

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AIM:To compare small sphincterotomy combined with endoscopic papillary large balloon dilation (SES + ELBD) and endoscopic sphincterotomy (EST) for large bile duct stones. METHODS:We compared prospectively SES + ELBD (group A, n = 27) with conventional EST (group B, n = 28) for the treatment of large bile duct stones (≥ 15 mm). When the stone could not be removed with a normal basket, mechanical lithotripsy was performed. We compared the rates of complete stone removal with one session and application of mechanical lithotripsy. CONCLUSION: SES + ELBD did not show significant benefits compared to conventional EST, especially for the removal of large (≥ 15 mm) bile duct stones. RESULTS:

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Section: Discussionmentioning

confidence: 99%

Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy

Kim¹,

Cheon²,

Cho³

et al. 2009

WJG

101

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show abstract

“…In expert hands and with the available necessary accessories, this rate rises to 95%, with a complication rate of about 10%, including a mortality rate of 1%. [3][4][5][6] There is still an ongoing debate about whether to perform ERCP for suspected choledocholithiasis before or after LC. 7 The aim of this study is to determine the usefulness of ERCP-EST in patients with symptomatic cholecystolithiasis and suspected choledocholithiasis prior to LC, and to determine the value of these procedures in the management of complications resulting from LC.…”

mentioning

confidence: 99%

Role of Endoscopic Retrograde Cholangiopancreatography Before and After Laparoscopic Cholecystectomy

et al. 1998

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Background: While the role of endoscopic retrograde cholangiopancreatography (ERCP) and. endoscopic sphincterotomy (EST) in the diagnosis and management of choledocholithiasis is well established, this study evaluates the usefulness of ERCP and EST in patients with symptomatic cholecystolithiasis and suspected choledocholithiasis before undergoing laparoscopic cholecystectomy (LC), and the role of ERCP-EST in the management of complications resulting from LC. Materials and Methods: This paper reviews retrospectively our experience from 1992 to 1995. A total of 1221 LCs and 717 ERCPs were performed, out of which 257 ERCPs were performed on 225 patients who underwent LC (230 ERCPs before and 27 after). The age range was 10-85 years (mean 43.5). The study group comprised 148 females (66%) and 77 males (34%). Results: The overall success rate for ERCP was 92% (96% for diagnostic and 88% for therapeutic). Choledocholithiasis was found at preoperative ERCP in 45% of cases. Prediction of choledocholithiasis was accurate in 46%, based on abnormal liver chemistry, and 70% when based on a combination of abnormal liver tests and dilated main bile duct (>7 mm) by ultrasound. In 40 cases of acute biliary pancreatitis, choledocholithiasis was found at ERCP in eight cases (20%). In the post-LC group, all eight cases with residual stones and seven of eight cases with bile leaks were successfully treated endoscopically. There were four cases with major duct injuries that required surgical management. The complications related to ERCP-EST included two cases of bleeding post-EST (one was controlled with injection therapy and the second one was managed surgically), and three cases of mild pancreatitis. Conclusion: ERCP and EST are effective and safe in the diagnosis and management of choledocholithiasis, and facilitate LC for symptomatic cholelithiasis. The procedures are also valuable in the diagnosis and management of most complications resulting from LC.

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“…A 55-year-old man was referred and admitted to our hospital because of repeated upper abdominal pain with pancreatic enzyme abnormalities after drinking a large quantity of alcohol on January 16,2002. He has 20 years' history of alcohol consumption 2 liter of beer a clay.…”

Section: Case Reportmentioning

confidence: 99%

“…However, severe stenosis and bending of' the pancreatic duct associated with chronic pancreatitis make it difficult to insert a basket. Endoscopic lithotripsy is also difficult in patients with multiple stones and constrictions, and can cause hemorrhage or perforation [16]. ESWL was first introduced by Sauerbruch et al [8] in 1987, and its safety and effectiveness in lithotripsy are well documented.…”

Section: And Conclusionmentioning

confidence: 99%

Effective Extracorporeal Shock Wave Lithotripsy for Pancreatic Duct Stone

Okabe

Ono²,

Suga³

et al. 2003

Kurume Med. J.

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Summary: A 55-year-old man with alcoholic chronic pancreatitis was hospitalized for further treatment of intractable repeated upper abdominal pain. A laboratory data showed normal hepatobiliary enzymes and glucose tolerance test, but abnormal pancreatic enzymes including amylase, lipase, trypsin and elastase I. Pancreatic function diagnostant test was 71 %. Abdominal ultrasound examination and computed tomography showed an approximately 4 mm main pancreatic duct stone and multiple small stones in the surrounding parenchyma, and the findings being compatible with chronic pancreatitis. Endoscopic retrograde cholangiopancreatrography revealed that there was a main pancreatic duct stone in the pancreas head, and that the caudal pancreatic duct could not be visualized due to the impacted stone. In addition, intrapancreatic bile duct showed no malignant irregularity, but pancreatitis-induced smooth narrowing. The patient underwent extracorporeal shock wave lithotripsy (ESWL) alone, because endoscopic manipulation for pancreatic stone removal was impossible due to tightly impacted stone with stenosis. Successful ESWL was achieved with the stone disappearance and without any complication.

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Endoscopic sphincterotomy: The whole truth

Cited by 123 publications

References 29 publications

Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy

Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy

Role of Endoscopic Retrograde Cholangiopancreatography Before and After Laparoscopic Cholecystectomy

Effective Extracorporeal Shock Wave Lithotripsy for Pancreatic Duct Stone

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