Long-term Results after Endoscopic Sphincterotomy Sotaro Fujimoto 1 1Department of Gastroenterology, Kyoto Second Red Cross Hospital pp.1181-1193
Published Date 1985/11/25
DOI https://doi.org/10.11477/mf.1403109701
  • Abstract
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 From August 1973 to May 1985, we performed 776 cases of endoscopic sphincterotomy (EST). In 762 cases (98.2%) of successful incision of the papilla of Vater, 726 cases (93.6%) showed a remarkable clinical effects. In our series, 32 early complications occurred in 776 cases (morbidity rate: 4.1%), and 2 fatalities were recognized (mortality rate: 0.26%).

 In this apper, we mainly discussed the propriety of EST by long-term follow-up study. In 326 cases with benign biliary diseases (biliary tract stone and papillary stenosis), we were able to analize a minute clinical course over one year after EST. Sixty-one cases (18.1%) in them complained of some symptoms (abdominal pain, fever or jaundice) after EST. Among them, 24 cases(7.4%) were found to have some late complications. The symptoms of remaining 37 cases were temporary and slight. Twenty-four cases with late complications consisted of 15 cases of recurrent stones after EST, six of cholecystitis and three of cholangitis. Five cases of recurrent stones and five cases of cholecystitis underwent a surgical treatment. The incision of the papilla of Vater at the initial EST was not full in 13 cases of recurrent stones and all cases of cholangitis. In 326 cases, there were 125 with the gallbladder with stone (70cases) or without stone (55 cases), and 201 who had been cholecystectomized. Six cases with cholecystitis after EST were leaving stones in the gallbladder, amounting to 8.6% of 70 cases with gallbladder stone. All the late complication occurred within five years after EST, and not involved a fatal case.

 EST gives the sufficient result in diagnosis and treatment for various diseases of biliary tract. Furthermore,EST was found to be a safe procedure from the low rates of comlications and fatalities.

Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.


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