Seifert E
1st Medical Department, Municipal Hospital Kemperhof, Koblenz, FRG.
Endoscopy. 1988 Aug;20 Suppl 1:232-5. doi: 10.1055/s-2007-1018182.
Long-term results after endoscopic sphincterotomy (EST) revealed disappearance or improvement of symptoms in 92.0%. The symptoms remained unchanged in 6.2% and deteriorated in only 1.8%. X-ray follow-up studies showed concrement-free bile ducts in 85.2%, recurrent stones in 11.3%, and a stenosis of EST in 3.5%. Satisfactory long-term results depend on the indication for EST. The results of EST for choledocholithiasis are much better than for papillary stenosis (symptom-free or improved = 91.7%: 83.7%, unchanged = 6.4%: 14.3%, deteriorated = 1.9%: 2.0%). An EST-related stenosis was more than five times more frequent (16.8%: 2.9%) in papillary stenosis than choledocholithiasis. A gallbladder in situ does not seem to be an additional risk factor after EST. Subsequent cholecystectomy was performed in only 16.2% (routinely and elective), and in only 2.0% as an emergency procedure. In approximately 50% of the cases aerobilia and reflux, and in about 100% bacteriocholia, are observed after EST. When the free outflow of bile is ensured, it is not probable that late secondary diseases will develop.
内镜括约肌切开术（EST）后的长期结果显示，92.0%的患者症状消失或改善。6.2%的患者症状无变化，仅1.8%的患者症状恶化。X线随访研究显示，85.2%的患者胆管内无结石，11.3%的患者复发结石，3.5%的患者存在EST狭窄。满意的长期结果取决于EST的适应证。EST治疗胆总管结石的结果远优于治疗乳头狭窄（无症状或症状改善者分别为91.7%和83.7%，无变化者分别为6.4%和14.3%，恶化者分别为1.9%和2.0%）。EST相关狭窄在乳头狭窄患者中的发生率（16.8%）是胆总管结石患者的五倍多（2.9%）。EST后胆囊原位存在似乎不是一个额外的危险因素。仅16.2%的患者随后进行了胆囊切除术（包括常规和选择性手术），作为急诊手术的仅占2.0%。EST后约50%的患者出现气胆和反流，约100%的患者出现胆系感染。当胆汁自由流出得到保证时，不太可能发生晚期继发性疾病。
