Urakami Y, Kishi S
Endoscopy. 1978 Nov;10(4):289-94. doi: 10.1055/s-0028-1098311.
Up to now, surgery was the only possible treatment for choledochoduodenal fistulas, which are seen more often in Japan than in Europe. This paper presents the value and effect of endoscopic fistulotomy (EFT) as an alternative treatment in those cases. Parapapillary choledochoduodenal fistulas are abserved usually on the longitudinal fold of the papilla or on its oral side. The papillotome is inserted into the common bile duct through the orifice of the duodenal papilla, then the wall between its orifice and the fistula is cut to open widely the distal portion of the choledochus. EFT was performed successfully in 7 cases. The procedure led to a wide open stoma of the distal common bile duct with free bile outflow. Residual stones, a common occurrence in cases of parapapillary choledochoduodenal fistulas, may pass spontaneously after EFT or can be removed with a basket catheter. In cases of parapapillary choledochoduodenal fistula, EFT is a reliable method, especially in high-risk patients, and an alternative to surgical treatment.
到目前为止，手术是胆总管十二指肠瘘唯一可行的治疗方法，这种瘘在日本比在欧洲更常见。本文介绍了内镜下瘘管切开术（EFT）作为这些病例替代治疗方法的价值和效果。乳头旁胆总管十二指肠瘘通常见于乳头的纵襞或其开口侧。将乳头切开刀通过十二指肠乳头开口插入胆总管，然后切开其开口与瘘管之间的壁，以广泛打开胆总管远端。7例患者成功实施了EFT。该手术使胆总管远端造口充分开放，胆汁自由流出。乳头旁胆总管十二指肠瘘病例中常见的残留结石，在EFT后可能自行排出，或可用网篮导管取出。对于乳头旁胆总管十二指肠瘘病例，EFT是一种可靠的方法，尤其适用于高危患者，是手术治疗的一种替代方法。
