Endoscopic management of choledocholithiasis and papillary stenosis.

Endoscopic papillotomy was performed in 50 of 53 patients, 31 females, with an age range of 29 to 87 years, a mean of 63.1. The indications for the procedure included retained or recurrent choledocholithiasis, primary choledocholithiasis and papillary stenosis, which were responsible for persistent or intermittent cholestasis. The procedure was successful in all but three patients in whom the primary diagnosis was papillary stenosis. The major complications were bleeding in three patients, pancreatitis in one patient and an infected pseudocyst in one patient. Surgical intervention was not required, and there were no deaths. Endoscopic papillotomy has proved to be safe, producing a permanent biliary enteric fistula, thus reducing the probability of formation of recurrent stones. It has been shown to reduce hospitalization and convalescence, permitting an earlier return to normal activity.