Unexpectedly, in the majority of patients symptoms did abate without any significant differences between groups in pain and quality of life. Patients that had high intensity and frequency of pain at randomization had a higher risk of experiencing subsequent events.
We found that non-operative expectant treatment carries a low risk of complications. Patients should be informed that watchful waiting is a safe option.
In 29 patients with gallstone pancreatitis, endoscopic papillotomy was performed during the first period (1976-1979) as elective procedure 1-8 weeks after the clinical symptoms had subsided. From 1979, endoscopic investigations and treatment were routinely done within 48 hours after the onset of clinical symptoms. The ERCPs and EPTs were well-tolerated and were performed without serious complications. The results of these series indicate that EPT can be safely performed in the acute stage of gallstone pancreatitis. Acute EPT gives effective drainage and relief of the acute symptoms in patients with obstructive pancreatitis.
These results suggest that 25 years after the JI bypass most of these patients have a similar level of mental and physical health as the general Norwegian female population. For individuals with bothersome side-effect(s) of the operation, a negative impact is seen.
A randomized trial of this nature is feasible but extremely difficult to perform because of the heterogeneous nature of gallbladder stone disease, leading to exclusion of many patients and difficulties in measuring and evaluating outcome variables.
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