Meyhoff H H
Acta Chir Scand. 1975;141(7):645-8.
A series of 106 patients with biliary tract stones is reported. The patients underwent supraduodenal choledochotomy, with an attempt to carry out conventional sanitation of the biliary tract, before a transduodenal sphincterotomy was done. Indication for sphincterotomy was mainly presence of wedged papillary stones or multiple common duct stones. Of the entire series, 52 attended for follow-up study after a period of at least 2 years postoperatively, and underwent intravenous cholangiography, 51 patients had papillary stones removed via the sphincterotomy. Stones were missed in 8 of 102 patients, but were passed spontaneously in 2 patients during the observation period. Postoperative mortality was high (10%)--4 patients developed a fatal pancreatitis. It is concluded that the procedure of sphincterotomy allows certain identification and removal of wedged papillary stones, but does not always allow that missed stones will be passed spontaneously. The possible significance of transpapillary drainage in the subsequent development of pancreatitis is considered.
报告了106例胆道结石患者。这些患者在进行十二指肠乳头括约肌切开术之前，先接受了十二指肠上胆总管切开术，试图对胆道进行常规清理。括约肌切开术的指征主要是嵌顿性乳头结石或多发性胆总管结石。在整个系列中，52例患者在术后至少2年进行了随访研究，并接受了静脉胆管造影，51例患者通过括约肌切开术取出了乳头结石。102例患者中有8例结石残留，但在观察期内有2例患者结石自行排出。术后死亡率较高（10%）——4例患者发生了致命性胰腺炎。得出的结论是，括约肌切开术能够明确识别并取出嵌顿性乳头结石，但并不总能使残留结石自行排出。文中考虑了经乳头引流在胰腺炎后续发展中的可能意义。
