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Acute cholangitis after endoscopic sphincterotomy: Complications of expectant treatment
Author(s) -
LAI E. C. S.,
CHOI T. K.,
FAN S.T.,
WONG J.
Publication year - 1989
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1989.tb01746.x
Subject(s) - medicine , major duodenal papilla , surgery , acute pancreatitis , common duct , common bile duct stone , common bile duct , decompression , pancreatitis , endoscopic treatment , endoscopic retrograde cholangiopancreatography , biliary tract , endoscopy
Two elderly patients who had endoscopic sphincterotomy (EST) for their common duct stones developed acute cholangitis and, one of them also developed acute pancreatitis after the procedure. Despite the presence of an adequate sphincterotomy which allows subsequent spontaneous stone elimination, transient ductal obstruction during stone migration through the sectioned papilla is probably accountable for their complications. From the present reported experience, it is clear that expectant treatment of common duct stone after EST can be associated with definite hazards. Immediate biliary decompression with either active instrumental extraction or, when not feasible, insertion of nasobiliary catheter, should be performed to prevent these complications in selected patients.