[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
June 1983

Endoscopic Papillotomy for Recurrent Common Bile Duct Stones and Papillary StenosisA Community Hospital Experience

Author Affiliations

From the Departments of Surgery (Drs Mazzeo and Jordan) and Gastroenterology (Dr Strasius), St Joseph Mercy Hospital, Ann Arbor, Mich.

Arch Surg. 1983;118(6):693-695. doi:10.1001/archsurg.1983.01390060015003

• Fifty-nine papillotomies were performed, 56 for biliary tract disease and three for papillary stenosis (secondary to carcinoma in two cases). All 56 patients with biliary tract disease had undergone previous cholecystectomies. Fifty-one of them had stones in the common duct, and in 41, all identified stones were removed. Stones were retained in ten patients, four of whom required surgical biliary tract exploration for extraction. Our results indicate that common bile duct stones with diameters 2.5 cm or greater should be approached surgically. Endoscopic papillotomy had an initial success rate of 80% for extraction of common bile duct stones and a late or actual success rate of 92%, confirmed by cholangiography. There were nine complications, including five episodes of bleeding (three requiring surgical intervention for control), giving an overall morbidity rate of 15.2%. The mortality was 3.4%. The procedure is indicated in the treatment of papillary stenosis and stones retained in the common bile duct after cholecystectomy.

(Arch Surg 1983;118:693-695)

Kawaisk K, Akasaka Y, Murakami K, et al:  Endoscopic sphincterotomy and the ampulla of Vater . Gastrointest Endosc 1974;20:148-151.Article
Classen M, Safrany L:  Endoscopic papillotomy and removal of gallstones . Br Med J 1975;4:371-374.Article
Safrany L:  Duodenoscopic sphincterotomy and gallstone removal . Gastroenterology 1977;72:338-345.
Classen M, Ossenberg FW:  Progress report: Non-surgical removal of common bile duct stones . Gut 1977;18:760-769.Article
Siegel JH:  ERCP update: Diagnostic and therapeutic applications . Gastrointest Radiol 1978;33:311-318.Article
Siegel JH:  Endoscopic retrograde cholangiopancreatography and endoscopic papillotomy . Curr Concepts Gastroenterol 1978;13:8-14.
Koch H, Rosch W, Schaffner O, et al:  Endoscopic papillotomy . Gastroenterology . 1977;73:1393-1396.
Safrany L:  Endoscopic papillotomy and removal of gallstones . Br Med J 1975;4:371-374.Article
Boehmig HJ, Fritsch A, Kux M, et al:  Indikationen und Ergebnisse der transduodenalen Sphincterotomie . Langenbecks Arch Chir 1969;323: 173-188.
Jones SA, Smith LL:  A reappraisal of sphincteroplasty (not sphincterotomy) . Surgery 1972;171:565-575.
Passi RB, Raval B:  Endoscopic papillotomy . Surgery 1982;92:581-588.
Ackeren H, Henning H, Soehendra N:  Erfahrungen uber die Papillotomie . Zentralbl Chir 1973;98:191-199.
Kiffmeyer D: Klinisch-experimentelle Untersuchung zur Pathophysiologie der transduodenalen Sphincterotomie, inaugural dissertation. Bonn, West Germany, 1973.
McSherry C, Glenn F:  The incidence and causes of death following surgery for non-malignant biliary tract disease . Ann Surg 1980;191:271-275.Article
Vellocott K, Powell P:  Exploration of the common bile duct: A comparative study . Br J Surg 1979;66:389-391.Article
Madden JL, Varco R, Delaney J (eds): Controversy in Surgery. Philadelphia, WB Saunders Co, 1976, p 239.