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There are some reports of gallstone ileus without fistula following endoscopic sphincterotomy (4).
It is necessary to undergo following examinations before deciding for endoscopic therapy: (i) Duodenoscopy with biopsy (vegetative duodenal lesion x ulcerations far from papilla), (ii) Intraampullar lesions require endosonography and miniprobe endoscopic sphincterotomy with collection of histological samples.
Furthermore, performing endoscopic sphincterotomy does not eliminate the risk of recurrent pancreatitis or other gallstone-related events, Dr.
The researchers randomly assigned 178 patients older than 60 who had concomitant gallstones (pigment stones) to either cholecystectomy or expectant management following endoscopic sphincterotomy and clearance of bile duct stones.
The efficacy of endoscopic sphincterotomy after cholecystectomy in patients with sphincter of Oddi dysfunction.
The ERCP procedure consists of an endoscopic sphincterotomy plus stone extraction.
Among the 116 patients who also underwent endoscopic sphincterotomy (a risk factor for acute pancreatitis), significantly fewer diclofenac patients (2 of 53) developed acute pancreatitis than did controls (12 of 63).
Indeed, multiple series indicate that endoscopic retrograde cholangiopancreatography with sphincter of Oddi manometry followed by endoscopic sphincterotomy causes pancreatitis in 20%-30% of treated patients.