[Influence of preoperative selective endoscopy on the results and treatment concept of bile duct surgery]

Abstract

Combined endoscopic and surgical intervention was undertaken in 728 consecutive patients with primary or secondary gallstone disease. In primary gallstone disease the combined treatment resulted in a residual stone rate of 1.28%, and 1.09% for the total group. Intervention on the lower biliary tract (n = 228) resulted in a morbidity rate of 7.4% and a mortality rate of 1.3%. The corresponding figures with purely endoscopic procedures were 1.2 and 0.0%, respectively. Intraoperatively manometrically tested papillary function after endoscopic papillotomy (EPT) revealed no significant difference from normal. In patients with proven biliary pancreatitis the mortality rate after EPT was 2.9%. These results indicate that routine inclusion of endoscopy into the surgical treatment concept for gallstone disease can improve the overall results.