Endoscopic sphincterotomy in choledocholithiasis: analysis of an experience of 530 interventions.

Authors

  • A Ginestal-Cruz Serviço de Medicina 2, Hospital de Santa Maria/Faculdade de Medicina de Lisboa.
  • N Grima
  • A P Correia
  • V Duarte
  • J P Correia

DOI:

https://doi.org/10.20344/amp.4563

Abstract

We report the experience of 530 consecutive cases of choledocolithiasis treated through Endoscopic Sphincterotomy (ES) between January 1980 and January 1988 (74% of total patients submitted to ES in the same period). 73% had more than 60 years and 47% more than 70 years. A slight majority (52%) had previous cholecystectomy (1/3 still with T-tube drainage) and the remaining had gallbladders insitu (lithiasic in 82%). Therapeutic goals (achieved drainage and complete stone removal) have been achieved in 95% of patients with a low immediate morbidity (9%) and mortality (1%). Delayed mortality, until 30th day (3%) includes 6 cases of obstructive cholangitis with sepsis, unaltered by emergent ES. Follow-up showed a 3% incidence of reintervention from restenosed ES. Patients with lithiasic gallbladder had a 33% cholecistectomy rate, mostly elective during first month post-ES. Our experience confirms ES as an efficient and safe routine treatment for choledocolithiasis. It should be the first choice in patients with previous cholecystectomy or alithiasic gallbladder and a largely applicable tool in those with associated gallbladder stones. Decision about post-ES cholecystectomy in these patients must be weighed on clinical grounds and according to surgical risk groups.

Downloads

Download data is not yet available.

How to Cite

1.
Ginestal-Cruz A, Grima N, Correia AP, Duarte V, Correia JP. Endoscopic sphincterotomy in choledocholithiasis: analysis of an experience of 530 interventions. Acta Med Port [Internet]. 1990 Jun. 30 [cited 2024 Mar. 28];3(3):133-40. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/4563

Issue

Section

Arquivo Histórico