Analysis of Results of Antergrade and Retrograde Endoscopic Papillotomy after Cholecystectomy


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Abstract

Relevance Frequency of occurrence of recurrent and residual choledocholithiasis is about 20%. We assign a special part to antegrade sphincterotomy (ST) in the treatment of intraductal pathology after cholecystectomy. It should be noted that reports about the above mentioned method are scarce (both in national and in foreign literature). The purpose of the study Size the possibilities of antegrade ST, when the pathology of major duodenal papilla (MDP) has been determinated after cholecystectomy. Materials and methods We have studied the results of treatment of obstruction of the extrahepatic bile duct after cholecystectomy in 166 patients. Study group comprised of 60 patients, who have undergone antergrade ST after cholecystectomy. The comparison group consisted of 106 patients who have undergone endoscopic retrograde PST after cholecystectomy. Results and their discussion Choledocholithiasis (43,5%), MDP stenosis (19,2%) and their combination (35,9%) dominate among the causes of intraductal pathology, requiring occasional surgical measures. Recovery after antegrade ST noted by 11,1% more, complications by 4,2% less and by 5,1% less of non-effective interventions were observed in comparison with retrograde ST. Occasional ST after antegrade ST required in 1,7%, which is 13,4% less in comparison with retrograde ST (p<0,001). Antegrade access allows to applicate intraductal interventions to stabilize the bile passage through the usage of transfistule manipulations in comparison with the isolated retrograde access.

About the authors

Ivanovo State Medical Academy, 8 Sheremet'evskii Ave., Ivanovo, 153012, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
Ph.D., Member editorial council of the journal "Journal of Experimental and Clinical Surgery", Associate Prof., Head of Department of General Surgery, Anesthesiology, Critical Care Medicine and Intensive Care of Ivanovo State Medical Academy of Health Ministry of Russia.

Ivanovo State Medical Academy, 8 Sheremet'evskii Ave., Ivanovo, 153012, Russian Federation

Email: author@vestnik-surgery.com
MD, Head of Department of Surgical Diseases of Ivanovo State Medical Academy of Health Ministry of Russia.

State Clinic of Emergency Medicine, 5 Gor'kogo Str., Vladimir, 600017, Russian Federation

Email: author@vestnik-surgery.com
Head of the X-ray angiosurgery of City Clinical Hospital first aid, Vladimir.

Ivanovo State Medical Academy, 8 Sheremet'evskii Ave., Ivanovo, 153012, Russian Federation

Email: author@vestnik-surgery.com
postgraduate student department of general surgery

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