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Is Oddi sphincterotomy an indication for hepatolithiasis?

By Xiaofeng Ling, Zhi Xu, Lixin Wang, Chunsheng Hou, Dianrong Xiu, Tonglin Zhang and Xiaosi Zhou


Background The purpose of treatment for hepatolithiasis is reducing recurrent cholangitis. This study was designed to determine the long-term outcome of Oddi sphincterotomy for hepatolithiasis. Methods Thirty-two consecutive hepatolithiasis patients, including 15 cases that had undergone conventional open surgical transduodenal sphincteroplasty (COSTS) and 17 cases with endoscopic sphincterotomy (EST), were followed up for a long term. We compared the post-treatment rates of recurrent cholangitis and acute cholangitis severe type (ACST) with the ones of pretreatment in each group, respectively. Paired chi(2) test was used. Results In the COSTS group, neither the post-operative rate of recurrent cholangitis (86.7%, 13/15 vs. 100%, 15/15) nor ACST (26.7%, 4/15 vs. 46.7%, 7/15) decreased (p > 0.05) compared with before the operation. In the EST group, the situation was the same: neither the rate of post-EST recurrent cholangitis (76.5%, 13/17 vs. 82.4%, 14/17) nor ACST (29.4%, 5/17 vs. 23.5%, 4/17) were reduced significantly (p > 0.05). Conclusions Both eradication of hepatobiliary lesions and keeping Oddi sphincter intact should be emphasized in the management of hepatolithiasis. Neither COSTS nor EST is an effective method or can achieve the goal of reducing cholangitis for hepatolithiasis.

Topics: Hepatolithiasis, Oddi sphincterotomy, Endoscopic sphincterotomy, Cholangitis, CHOLANGIOSCOPIC LITHOTOMY, STONES
Publisher: surgical endoscopy and other interventional techniques
Year: 2009
DOI identifier: 10.1007/s00464-008-0304-3
OAI identifier: oai:localhost:20.500.11897/197694
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