A discussion on indications of endoscopic sphincterotomy / 中国微创外科杂志

ABSTRACT

Objective To investigate proper indications of endoscopic sphincterotomy (EST). Methods A retrospective review was made on 9 cases of EST with controversial indications from January 2005 to January 2006 in this hospital. There were 1 case of jaundice due to hepatitis and intrahepatic cholestasis, 1 case of intrahepatic and extrahepatic cholelithiasis, 1 case of common bile duct stones, 2 cases of bile duct obstruction due to malignant tumors at upper (1 case) or lower segment (1 case), 2 cases of papillary tumors, 1 case of choledochal cyst, and 1 case of gallstones accompanying common bile duct stones. Results Except for 1 case of jaundice due to hepatitis and intrahepatic cholestasis misdiagnoed as having obstructive jaundice, surgical indications presented in 8 cases. Of the 8 cases, 5 cases were given a surgical operation following EST, 1 case was inoperable because of worse general condition after EST, and a radical operation was given up in 2 cases of end-stage tumors. Conclusions Without complete relief of proximal bile duct obstruction, EST may worsen the patient’s condition instead of curing the biliary diseases. EST may be unnecessary for resectable tumors, especially in young patients.