Endoscopic papillotomy and removal of gall stones.

Classen, Meinhard; Sáfrány, L

doi:10.1136/bmj.4.5993.371

Cited by 80 publications

(34 citation statements)

References 6 publications

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“…The method of endoscopic sphincterotomy has been described elsewhere [1,2]. It is performed in the endoscopy unit with the patient sedated using a side-view Olympus duodenoscope or video endoscope under fluoroscopic control.…”

Section: Methodsmentioning

confidence: 99%

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Endoscopic Management of Bile Duct Stones at Riyadh Military Hospital: An Eight-Year Experience

Al-Karawi

Mohamed

1991

Ann Saudi Med

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Section: Methodsmentioning

confidence: 99%

“…Since the introduction of endoscopic sphincterotomy for biliary stone extraction in the early 1970s [1,2], there have been several reports on the successful extraction of biliary stones using this method [3,4]. Subsequently, endoscopic papillotomy has been used successfully in the treatment of disorders other than biliary stones.…”

mentioning

confidence: 99%

Endoscopic Management of Bile Duct Stones at Riyadh Military Hospital: An Eight-Year Experience

Al-Karawi

Mohamed

1991

Ann Saudi Med

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“…After a complete evaluation of the patient utilizing all radiographic, radioisotopic, and ultrasonographic techniques, endoscopic evaluation is performed during ERCP to localize mucosal lesions not appreciated by other contrast studies increasing diagnostic yield. [11,12] was perfected as an alternative to surgical i n t e r v e n t i o n in high-risk patients with retained or recurrent gallstones a n d stenosis a n d has proven to be a safe n o n o p e r a t i v e technique specifically for this purpose. The m o r b i d i t y and mortality of the endoscopic group [28,29] are greatly reduced from that of surgical series [30], and the period of convalescence has been shortened to only a few days.…”

Section: Abdominal Painmentioning

confidence: 99%

“…The ability to cannulate the papilla of Vater under direct vision to facilitate the opacification of the ductular structures of the biliary tract and pancreas has influenced our current approach to these problems by providing an expedient diagnosis and, thus, specific management. The capability of removing gallstones from the common bile duct and relieving stenosis of the duct has become a reality through endoscopic papillotomy (EP) [11,12], the newest application of ERCP.…”

mentioning

confidence: 99%

ERCP update: Diagnostic and therapeutic applications

Siegel

1978

Gastrointest Radiol

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Endoscopic retograde cholangiopancreatography (ERCP) is currently utilized to evaluate jaundice, both intra- and extrahepatic, and can differentiate between these by demonstrating specific anatomic lesions. ERCP is definitive in the evaluation of gallbladder disease when other modalities are indefinite. For the first time outside the operating room, the pancreatic duct can be opacified by ERCP. The newest application of ERCP, endoscopic papillotomy (EP), has revolutionized the treatment of common bile duct gallstones and stenosis of the duct, offering a safe and effective alternative to repeated surgery, especially in those patients at risk. Because of these diverse and effective applications, ERCP has become firmly established in our diagnostic armamentarium.

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“…Classically, the surgery by laparotomy for access to the main biliary tract constituted the standard treatment for choledocholithiasis, preceding choledocholithotomy and external biliary drainage (80) . In the 70's, the introduction of the retrograde endoscopic cholangiography and subsequently papillotomy permitted a therapeutic alternative, especially in those patients that had previously been subject to cholecystectomy (12,17,23,44) . With the advent of videolaparoscopic surgery, the endoscopic approach became an important complementary procedure, recommended in the preoperative, when used for the diagnosis of choledocholithiasis, as well as in the postoperative period (9,32,34,46) .…”

Section: Introductionmentioning

confidence: 99%

Common bile duct stones: analysis of the videolaparoscopic surgical treatment

Santo

Domene

Riccioppo

et al. 2012

Arq. Gastroenterol.

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-Context -About 9% of the Brazilian population has gallstones and the incidence increases significantly with aging. The choledocholithiasis is found around 15% of these patients, and a third to half of these cases presented as asymptomatic. Once the lithiasis in the common bile duct is characterized through intraoperative cholangiography, the laparoscopic surgical exploration can be done through the transcystic way or directly through choledochotomy. Objective -To evaluate the results and outcomes of the laparoscopic treatment of common bile duct lithiasis. Methods -Seventy consecutive patients were evaluated. They prospectively underwent the treatment of the lithiasis in the common bile duct and the exploration ways were compared according to the following parameters: criteria on their indication, success in the clearance, surgical complications. It was verified that about ½ of the choledocholithiasis carriers did not show any expression of predictive factors (clinical antecedents of jaundice and/or acute pancreatitis, compatible sonographic data and the pertaining lab tests). The laparoscopic exploration through the transcystic way is favored when there are no criteria for the practice of primary choledochotomy, which are: lithiasis in the proximal bile duct, large (over 8 mm) or numerous calculi (multiple calculosis). Results -The transcystic way was employed in about 50% of the casuistic and the choledochotomy in about 30%. A high success rate (around 80%) was achieved in the clearance of the common bile duct stones through laparoscopic exploration. The transcystic way, performed without fluoroscopy or choledochoscopy, attained a low rate of success (around 45%), being 10% of those by transpapilar pushing of calculi less than 3 mm. The exploration through choledochotomy, either primary or secondary, if the latter was performed after the transcystic route failure, showed high success rate (around 95%). When the indication to choledochotomy was primary, the necessity for choledochoscopy through choledochotomy to help in the removal of the calculi was 55%. However, when choledochotomy was performed secondarily, in situations where the common bile duct diameter was larger than 6 mm, the use of choledochoscopy with the same purpose involved about 20% of the cases. There was no mortality in this series. Conclusion -The laparoscopic exploration of the common bile duct was related to a low rate of morbidity. Therefore, the use of laparoscopy for the treatment of the lithiasis in the common bile duct depends on the criteria for the choice of the best access, making it a safe procedure with very good results. HEADINGS -Choledocholithiasis. Laparoscopy. Cholangiography.

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Endoscopic papillotomy and removal of gall stones.

Cited by 80 publications

References 6 publications

Endoscopic Management of Bile Duct Stones at Riyadh Military Hospital: An Eight-Year Experience

Endoscopic Management of Bile Duct Stones at Riyadh Military Hospital: An Eight-Year Experience

ERCP update: Diagnostic and therapeutic applications

Common bile duct stones: analysis of the videolaparoscopic surgical treatment

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