RESUMO
Patients with cholecysto- and choledocholithiasis may benefit from the advantages of laparoscopic cholecystectomy by intraoperative common bile duct exploration or preoperative endoscopic papillotomy (EPT) with stone removal. We performed therapeutic splitting in 94 patients. Morbidity was 4.2% and mortality was zero. A follow up study of 50 patients shows residual stones in 2% and papillary stenosis in 2%. We believe our results, supported by data on EPT in the literature, show that two-stage endoscopic stone removal prior to laparoscopic cholecystectomy is a safe and effective method for treating cholecystolithiasis combined with choledocholithiasis.
Assuntos
Colecistectomia Laparoscópica , Cálculos Biliares/cirurgia , Esfinterotomia Endoscópica , Adulto , Idoso , Idoso de 80 Anos ou mais , Colecistectomia Laparoscópica/instrumentação , Terapia Combinada , Feminino , Cálculos Biliares/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Esfinterotomia Endoscópica/instrumentação , Técnicas de Sutura/instrumentaçãoRESUMO
Therapeutical splitting consisting of endoscopic sphincterotomy, stone removal and laparoscopic cholecystectomy is a valuable alternative method compared to open cholecystectomy with common bile duct exploration. In our prospective study we performed this procedure in 89 patients (28.7.1990-28.7.1993). Morbidity was 4.5% and mortality was 0. A follow-up study of 50 patients shows residual stones in 2% and papillary stenosis in 2%.