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 23 May 2018

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News

Should cholecystectomy always follow sphincterotomy for gallstone cholangitis?

Combining endoscopic and laparascopic approaches is a "safe and effective" method of managing gallstone cholangitis, according to a report in the Archives of Surgery.

News image

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Surgeons at the Queen Mary Hospital, Hong Kong, China, reported on the treatment of 184 patients over a three-year period.

Patients were given endoscopic retrograde cholangiopancreatography (ERCP) together with endoscopic sphincterotomy. 101 patients went on to have laparascopic cholecysectomy.

The surgeons led by Ronnie Tung-Ping Poon, report that ERCP was successful in 175 patients and that bile duct stones were found in 147.

In 132 of these patients, the sphincterotomy technique was used successfully to clear stones.

A total of three patients died from cholangitis.

Recurrent biliary symptoms in patients over 2-year follow-up:
Cholecystectomy 6%
Retained gall bladder 25%
Arch Surg

During a two-year follow-up period, recurrent biliary symptoms were reported by six of the 101 patients who had gall-bladder removal and 18 of 73 patients who retained the gall bladder.

The surgeons said this indicated that leaving the gall bladder in place after sphincterotomy increased the risk of further symptoms.

"Laparoscopic cholescystectomy should be recommended after endoscopic management of cholangitis except in patients with prohibitive surgical risk," they write.

Report Copyright: Englemed Health News at http://www.internationalmedicalnews.com

Arch Surg 2001; 136 (1): 11-16
23 January 2001

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