Solhaug J H, Fokstuen O, Rosseland A, Rydberg B
Acta Chir Scand. 1984;150(6):475-8.
Endoscopic papillotomy was performed for choledocholithiasis in 22 high-risk patients with gallbladder in situ. The procedure was well tolerated by the patients and was performed without serious complications. Pathologic laboratory findings normalized in most cases during the first week after papillotomy. The median hospital stay was four days. Laparotomy was subsequently performed in five cases, in one because of impaction of a 3 cm stone two days after the papillotomy, and in four because of biliary symptoms during a five-year follow-up period. On the basis of experience with this patient series and recent reports in the literature, primary endoscopic papillotomy is recommended as the sole therapeutic procedure for high-risk patients.
对22例原位胆囊的高危胆总管结石患者实施了内镜乳头切开术。患者对该手术耐受性良好，且手术过程中未出现严重并发症。多数病例在乳头切开术后第一周内病理实验室检查结果恢复正常。中位住院时间为4天。随后5例患者接受了剖腹手术，其中1例是因为乳头切开术后两天出现3厘米结石嵌顿，另外4例是因为在五年随访期内出现胆道症状。基于该患者系列的经验以及近期文献报道，建议将原发性内镜乳头切开术作为高危患者的唯一治疗方法。
