Primary endoscopic papillotomy (EPT) in patients with stones in the common bile duct and the gallbladder in situ: a 5-8-year follow-up study.

Abstract

AbstractSeventy‐five patients (mean age, 77 years) with common duct stones and the gallbladder in situ were treated with primary endoscopic papillotomy (EPT) during the period 1976–1979. The endoscopic procedure was successful in all patients, but 4 patients had to be operated on since the common duct stone did not pass.The complication rate was 13.3% and 1 patient died. One patient was operated on with cholecystectomy within a week after EPT because of progression of his cholecystitis. Another patient was operated on with drainage for perforated liver abscesses and cholecystectomy; she also died 1 week after operation.In the follow‐up period of 5–8 years, 12 patients were operated on with cholecystectomy: 7 patients because of acute cholecystitis, and 3 patients because of recurrent pain attacks. In 2 patients, the operation was done electively.Thirty patients died, all from other diseases except 1 patient who died from a gallbladder carcinoma 1 1/2 years after EPT. Three patients were treated conservatively for acute cholecystitis.After 5 years, 28 patients were still alive with the gallbladder in situ and none had symptoms from the gallbladder. Altogether, 13 (17.3%) patients were treated for acute cholecystitis during the 5–8‐year follow‐up period.