Linked Life Data

2666342

Source:http://linkedlifedata.com/resource/pubmed/id/2666342

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1989-9-5
pubmed:abstractText
One hundred and ten subjects with cholelithiasis entered this retrospective study. Early and late results of 73 patients treated by endoscopic papillosphincterotomy (EPST) were compared to those of 37 patients who had surgical transduodenal papillo-sphincteroplasty (SST). The comparative analysis was made in terms of clinical, biochemical and ultrasonographic findings. The follow-up period ranged from 1 to 5 years in the first group and from 1 to 15 years in the second group. EPST and SST proved to be comparable in regard to operative mortality and morbidity. EPST failed in removing large or impacted bile duct stones in 47% of cases, while SST was uniformly successful. Long-term results were good in most patients, either when treated by EPST or SST. The 5-year failure rate was 8% after EPST and 0% after SST. In the surgical group, the 15-year failure rate was 5%. Serum alkaline phosphatase levels were higher after EPST than after SST, suggesting the persistence of some degree of biliary stasis in endoscopically managed patients. Pneumobilia was detected more often in surgical patients, indicating that SST does create a wide and permanent communication between the duodenum and the biliary system. In conclusion: 1) EPST may achieve acceptable success rates with low mortality and morbidity, even in high risk patients; 2) the high number of long-term good clinical results seems to indicate that sphincter re-stenosis after EPST is rare, at least for the first 5 years from operation; 3) SST is an effective and safe procedure, ensuring excellent long-term results, provided that the technique of and the indication for are correct (including Wirsung assessment); 4) the wide and permanent stoma created by SST is not associated with recurrent cholangitis, if bile duct re-stenosis does not occur.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
0392-3525
pubmed:author
pubmed:issnType
Print
pubmed:volume
19
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
165-71
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
1989
pubmed:articleTitle
Endoscopic papillosphincterotomy and surgical sphincteroplasty for the treatment of bile duct stones: a comparative analysis.
pubmed:affiliation
Semeiotica Chirurgica 1, Università di Genova.
pubmed:publicationType
Journal Article, Comparative Study