Koch H, Rösch W, Schenk J, Demling L
MMW Munch Med Wochenschr. 1979 Apr 27;121(17):587-90.
Endoscopic papillotomy is a method of incising the papillary spincters without opening the abdominal wall or the duodenum. It is successful in over 95% of cases. In over 80% of cases passage of choledochus concrement occurs, about half of these stones being excreted spontaneously and the rest having to be extracted actively with a small Domia basket. For large concrements which cannot be removed endoscopically even after wide papillotomy incision, there is the electrohydraulic lithotrite which crushes them so that they can be passed spontaneously or be actively extracted. Dissolution by a substance instilled through a catheter passed through the papilla into the common bile duct is still in the experimental stage. Altogether for this reason endoscopic papillotomy and removal of stones is an advance for the patient at risk, as it involves a lower lethality than the corresponding surgical method.
内镜下乳头切开术是一种无需切开腹壁或十二指肠即可切开乳头括约肌的方法。该方法在超过95%的病例中取得成功。超过80%的病例会出现胆总管结石排出,其中约一半的结石可自行排出,其余的则需用小网篮积极取出。对于即使在进行广泛的乳头切开术后仍无法通过内镜取出的大结石,可使用电液压碎石器将其击碎,以便结石能够自行排出或被积极取出。通过经乳头插入胆总管的导管注入某种物质进行溶解仍处于实验阶段。综上所述,内镜下乳头切开术及取石术对于高危患者来说是一种进步,因为与相应的手术方法相比,其致死率更低。