Freeman M L
Division of Gastroenterology, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
Endoscopy. 1997 May;29(4):288-97. doi: 10.1055/s-2007-1004193.
Short-term complications of sphincterotomy can vary widely in different circumstances, and appear to be related primarily to two factors: the indication for the procedure, and the technical skill of the endoscopist. The risk of sphincterotomy is highest when it is performed for suspected sphincter of Oddi dysfunction, and lowest when it is performed for bile duct stone extraction in tandem with laparoscopic cholecystectomy. The endoscopic technique is an important factor in complications, and this is in turn related to the case volume, and presumably the skill and training of the endoscopist. With the exception of cirrhosis and perhaps other specific conditions, the patient's general medical condition appears to have little impact on the overall risk of sphincterotomy. Complications represent only one facet of negative outcomes in attempted sphincterotomy: failure to achieve bile duct access at all, failure of completed sphincterotomy to achieve its intended therapeutic response, and its long-term sequelae, may be at least as important in determining the overall outcome of sphincterotomy.
括约肌切开术的短期并发症在不同情况下差异很大，似乎主要与两个因素有关：手术指征和内镜医师的技术水平。当因怀疑奥狄括约肌功能障碍而进行括约肌切开术时，其风险最高；而与腹腔镜胆囊切除术同时进行胆管结石取出术时，风险最低。内镜技术是并发症的一个重要因素，这又与病例数量相关，大概也与内镜医师的技能和培训有关。除了肝硬化以及可能的其他特定情况外，患者的一般健康状况似乎对括约肌切开术的总体风险影响很小。并发症只是括约肌切开术不良后果的一个方面：完全无法进入胆管、完成的括约肌切开术未能达到预期治疗效果及其长期后遗症，在决定括约肌切开术的总体结果方面可能至少同样重要。
