PMID- 14607662
OWN - NLM
STAT- MEDLINE
DCOM- 20040121
LR  - 20220316
IS  - 1499-3872 (Print)
VI  - 2
IP  - 1
DP  - 2003 Feb
TI  - Endoscopic diagnosis and treatment of post-cholecystectomy syndrome.
PG  - 117-20
AB  - OBJECTIVE: To assess the value of endoscopy in the etiological diagnosis and 
      treatment of post- cholecystectomy syndrome (PCS). METHODS: 386 patients with PCS 
      were given endoscopic retrograde cholangiopancreatography (ERCP). Having been 
      made the etiology clear, patients with choledocholithiasis were subjected to 
      endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilatation (EPBD) 
      to extract stones, those with papillary inflammatory stricture to EST or EPBD, 
      those with papillary diverticulum and sphincter of Oddi dysfunction (SOD) to 
      EPBD, those with papillary tumor and hepatobiliary tumor to endoscopic metal 
      biliary endoprosthese (EMBE), and those with biliary stricture in the mid bile 
      duct, purulent cholangitis, choledocholithiasis (stones not extracted one time) 
      and bile leakage to endoscopic nose-biliary drainage (ENBD). RESULTS: ERCP was 
      performed successfully in 371 patients (96.1%). No abnormalities were found 
      endoscopically in 30 patients. In 243 patients with choledocholithiasis, 235 had 
      stones removed after one to three times. Thirty-nine patients with papillary 
      inflammatory stricture were successfully treated with EST or EPBD. Nine patients 
      with papillary diverticulum which oppressed the papillary opening and 7 patients 
      with SOD were also successfully treated with EPBD. In 16 patients with stricture 
      in the mid bile duct, 11 showed improvement after ENBD. Six patients with 
      papillary tumor and 5 patients with hepatobiliary stricture after EMBE showed 
      significant alleviation of jaundice. Six patients with bile leakage caused by 
      cholecystectomy received ENBD successfully, avoiding re-operation. Six patients 
      developed gastroduodenal ulcer and 4 residual stones in the cholecystic duct. 
      Complications occurred in 21 patients (5.7%). CONCLUSIONS: ERCP may detect the 
      etiology of post-cholecystectomy syndrome at early stage, and therapeutic 
      measures can be taken accordingly in clinical practice.
FAU - Zhou, Ping-Hong
AU  - Zhou PH
AD  - Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 
      200032, China. chow@zshospital.net
FAU - Liu, Feng-Lin
AU  - Liu FL
FAU - Yao, Li-Qing
AU  - Yao LQ
FAU - Qin, Xin-Yu
AU  - Qin XY
LA  - eng
PT  - Journal Article
PL  - Singapore
TA  - Hepatobiliary Pancreat Dis Int
JT  - Hepatobiliary & pancreatic diseases international : HBPD INT
JID - 101151457
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Ampulla of Vater
MH  - Catheterization/*methods
MH  - Cholangiopancreatography, Endoscopic Retrograde/*methods
MH  - Common Bile Duct Diseases/*diagnosis/surgery/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postcholecystectomy Syndrome/*diagnosis/surgery/*therapy
MH  - Sphincterotomy, Endoscopic/*methods
EDAT- 2003/11/11 05:00
MHDA- 2004/01/22 05:00
CRDT- 2003/11/11 05:00
PHST- 2003/11/11 05:00 [pubmed]
PHST- 2004/01/22 05:00 [medline]
PHST- 2003/11/11 05:00 [entrez]
AID - 467 [pii]
PST - ppublish
SO  - Hepatobiliary Pancreat Dis Int. 2003 Feb;2(1):117-20.