PMID: 8598755Apr 6, 1996Paper

Randomised trial of endoscopic sphincterotomy with gallbladder left in situ versus open surgery for common bileduct calculi in high-risk patients

Lancet
E M TargaronaM Trías

Abstract

Morbidity and mortality after surgical treatment of bileduct stones increase with age and associated diseases. A proposed alternative therapy is endoscopic sphincterotomy (ES) with the gallbladder left in situ, and we elected to compare this option with standard open surgery in high-risk patients. 98 patients (mean age 80 years) with symptoms likely to be due to bileduct stones or a recent episode of biliary pancreatitis were randomised to be treated either by open cholecystectomy with operative cholangiography and (if necessary) bileduct exploration (n=48) or by endoscopic sphincterotomy alone (n=50). The procedure was accomplished successfully in 94% of the surgery group and 88% of the ES group, and there were no significant differences in immediate morbidity (23% vs 16%) or mortality (4% vs 6%). During mean follow-up of 17 months biliary symptoms recurred in three surgical patients, none of whom underwent repeat surgery, and in 10 ES patients, seven of whom had biliary surgery. By multivariate regression analysis endoscopic sphincterotomy was an independent predictor of recurrent biliary symptoms (odds ratio 6.9; 95% Cl 1.46 to 32.54). In elderly or high-risk patients, surgery is preferable to endoscopic sphincterotomy with ...Continue Reading

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Mar 16, 2021·Lars Tue Sorensen

References

Mar 1, 1991·Baillière's Clinical Gastroenterology·M C Winslet, J P Neoptolemos
May 1, 1991·The British Journal of Surgery·J HillD E Tweedle
Feb 1, 1988·Annals of Surgery·B M MillerL W Traverso
Jul 1, 1995·Gastroenterology·S M Strasberg, N J Soper
Nov 1, 1994·The British Journal of Surgery·A Nassar
Jun 1, 1994·The British Journal of Surgery·J PerissatJ P Neoptolemos

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Citations

Oct 1, 2004·World Journal of Surgery·Andrew L TambyrajaStephen J Nixon
Jul 19, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Kaori ItoEdward E Whang
Oct 19, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Mark BignellMichael Rhodes
Sep 15, 2000·The Surgical Clinics of North America·D N Reed, G C Vitale
Sep 21, 2002·Lancet·Alfred Cuschieri
Aug 5, 2009·Nature Reviews. Gastroenterology & Hepatology·John G Lee
Apr 1, 1997·Journal of Clinical Gastroenterology·C R Kapadia
Dec 19, 2002·Journal of Clinical Gastroenterology·Robert Michael Stephen MitchellWilliam Dickey
Jan 25, 2006·Annals of Surgery·Stefan HeinrichPierre-Alain Clavien
Mar 5, 1999·BMJ : British Medical Journal·T C Tham, D L Carr-Locke
Aug 1, 1997·Thorax·J Richardson, S Sabanathan
Mar 13, 2013·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Rafael S MarcariJosé Francisco de Matos Farah
Feb 4, 2014·Best Practice & Research. Clinical Gastroenterology·A H van DijkP R de Reuver
Jun 9, 2007·European Journal of Gastroenterology & Hepatology·Takeshi TsujinoMasao Omata
May 2, 2002·ANZ Journal of Surgery·Christopher J MartinLisa Vaccaro
Mar 12, 2008·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Eduardo M Targarona, Gali Even Bendahan
Feb 29, 2008·American Journal of Surgery·Kaori ItoEdward E Whang
Jun 27, 2007·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·N AlexakisJ P Neoptolemos
Nov 28, 2006·Best Practice & Research. Clinical Gastroenterology·Djamila Boerma, Matthijs P Schwartz
Jul 3, 2008·ANZ Journal of Surgery·Geoffrey P KohnRichard J Cade
Dec 17, 2009·Journal of Hepato-biliary-pancreatic Sciences·Yasutoshi KimuraTetsuhide Ito
Dec 5, 2006·Gastrointestinal Endoscopy·Eva FritzPeter Knoflach
Jan 13, 2006·Gastroenterology·David L Carr-Locke
Feb 13, 2015·Surgical Endoscopy·Simon BergmanShannon A Fraser
Dec 31, 2003·Gastroenterology Clinics of North America·Ian F YusoffAlan N Barkun
May 15, 2015·Journal of Hepato-biliary-pancreatic Sciences·Masamichi YokoeKoichi Hirata
Aug 5, 2015·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Haicheng YuanSanyuan Hu
Oct 5, 2010·Gastrointestinal Endoscopy·Jean Louis Frossard, Philippe M Morel
Nov 26, 2002·The British Journal of Surgery·S E Tranter, M H Thompson
Nov 26, 2002·The British Journal of Surgery·M H Thompson, S E Tranter

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