Roberts-Thomson I C, Toouli J
Gastrointest Endosc. 1985 Dec;31(6):370-3. doi: 10.1016/s0016-5107(85)72250-x.
Between 1979 and 1983, 50 patients were treated by endoscopic sphincterotomy for disabling biliary-type pain after cholecystectomy. Forty-six patients were seen at regular intervals for at least 12 months after the procedure and of these, pain resolved in six (13%), decreased in severity and/or frequency in 22 (48%), and continued unchanged in 18 (39%). Patients with bile duct dilation on a retrograde cholangiogram had a similar outcome to those with a bile duct of normal caliber. Twenty-five patients had a morphine-neostigmine test and endoscopic manometry of the sphincter of Oddi prior to the procedure, and the outcome appeared to be independent of results from these investigations. Subgroups of patients who benefit from sphincterotomy will be determined only by prospective studies in which criteria for inclusion are carefully defined so as to avoid heterogeneity within study groups.
1979年至1983年间，50例患者因胆囊切除术后出现顽固性胆绞痛接受了内镜括约肌切开术治疗。46例患者在术后定期接受了至少12个月的随访，其中6例（13%）疼痛缓解，22例（48%）疼痛严重程度和/或发作频率降低，18例（39%）疼痛持续未变。逆行胆管造影显示胆管扩张的患者与胆管管径正常的患者预后相似。25例患者在手术前进行了吗啡-新斯的明试验和Oddi括约肌内镜测压，结果似乎与这些检查结果无关。只有通过前瞻性研究才能确定从括约肌切开术中获益的患者亚组，在前瞻性研究中，应仔细定义纳入标准，以避免研究组内的异质性。
