AIM: To analyze the indications, effi cacy and safety of sphincteroplasty in our centre. METHODS: A retrospective study of sphincteroplasty in 53 cases of papilla at high risk was performed in 2004-2006. The procedure...AIM: To analyze the indications, effi cacy and safety of sphincteroplasty in our centre. METHODS: A retrospective study of sphincteroplasty in 53 cases of papilla at high risk was performed in 2004-2006. The procedure consisted of duodenoscopy with Olympus TJF 145 Videoduodenoscope, approach to the biliary tract using a catheter with a guidewire, and dilatation of the papilla with a dilatation balloon catheter using a syringe with a manometer for control of the fi lling pressure. RESULTS: The indications included intradiverticular papilla in 26 patients (49/), stenosis of a previous sphincterotomy in 19 patients (35.8/), small size of the papilla in 4 patients (7.5/), Billroth Ⅱ gastrectomy in 3 patients (5.6/), and coagulopathy in one patient (1.9/). The efficacy was 97.8/, with all the calculi extracted from the common bile duct in 84.4/ of the patients, even though 21 of the patients (39.6/) had calculi with a diameter equal to or greater than 10 mm. Seven patients (13.2/) presented complications: haemorrhage in 1 patient (1.9/) and mild pancreatitis in 6 patients (11.3/). The mean hospital stay in case of complications was of 3 ± 0.63 d. CONCLUSION: Sphincteroplasty is highly effective, with a complication rate similar to that of sphincterotomy, furthermore, the complications are of low clinical importance. The use of the 10 mm balloon makes it possible to extract calculi with a diameter of over 15 mm and to extract more than 3 calculi without increasing the rate of complications and reduces the need to resort tolithotripsy or rescue sphincterotomy.展开更多
文摘AIM: To analyze the indications, effi cacy and safety of sphincteroplasty in our centre. METHODS: A retrospective study of sphincteroplasty in 53 cases of papilla at high risk was performed in 2004-2006. The procedure consisted of duodenoscopy with Olympus TJF 145 Videoduodenoscope, approach to the biliary tract using a catheter with a guidewire, and dilatation of the papilla with a dilatation balloon catheter using a syringe with a manometer for control of the fi lling pressure. RESULTS: The indications included intradiverticular papilla in 26 patients (49/), stenosis of a previous sphincterotomy in 19 patients (35.8/), small size of the papilla in 4 patients (7.5/), Billroth Ⅱ gastrectomy in 3 patients (5.6/), and coagulopathy in one patient (1.9/). The efficacy was 97.8/, with all the calculi extracted from the common bile duct in 84.4/ of the patients, even though 21 of the patients (39.6/) had calculi with a diameter equal to or greater than 10 mm. Seven patients (13.2/) presented complications: haemorrhage in 1 patient (1.9/) and mild pancreatitis in 6 patients (11.3/). The mean hospital stay in case of complications was of 3 ± 0.63 d. CONCLUSION: Sphincteroplasty is highly effective, with a complication rate similar to that of sphincterotomy, furthermore, the complications are of low clinical importance. The use of the 10 mm balloon makes it possible to extract calculi with a diameter of over 15 mm and to extract more than 3 calculi without increasing the rate of complications and reduces the need to resort tolithotripsy or rescue sphincterotomy.
