Surgical management of complications of endoscopic sphincterotomy with precut papillotomy.

Abstract:

:We reviewed 574 endoscopic sphincterotomy procedures. Fifty-six precut papillotomies were performed. Presenting conditions included choledocholithiasis, cholangitis, benign and malignant papillary strictures, and stenosing papillitis. Complications were identified in 16 percent: perforation in 9 percent, pancreatitis in 5 percent, bleeding in 2 percent, and pancreatic abscess in 2 percent. One patient died. Six patients required operation for complications. Perforation of the duodenum or common bile duct seen within 8 hours was managed with drainage and closure of the perforation with minimal complications. Duodenal perforations operated on later than 8 hours required more extensive procedures. All these patients had significant post-operative complications. Three patients were managed nonoperatively. Precut papillotomy carries a significantly higher complication rate than conventional sphincterotomy. Our experience suggests that there is no place for conservative management of duodenal perforation.

journal_name

Am J Surg

authors

Booth FV,Doerr RJ,Khalafi RS,Luchette FA,Flint LM Jr

doi

10.1016/s0002-9610(05)80618-x

subject

Has Abstract

pub_date

1990-01-01 00:00:00

pages

132-5; discussion 135-6

issue

1

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(05)80618-X

journal_volume

159

pub_type

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