Endoscopic papillotomy.

Obstruction of the common bile duct can now be relieved by endoscopic electrosurgery. This report describes our experience with 267 patients. In 192 of 222 patients with choledocholithiasis all calculi were evacuated by endoscopic papillotomy (EP). The remaining patients had EP because of papillary stenosis. Complications of EP included nine instances of pancreatitis, seven of bleeding, and two perforations. In 2 of 32 patients having EP for papillary stenosis, restenosis has appeared on follow-up. The two fatalities were attributable to purulent cholangitis and acute bleeding. This required to manage these situations. The endoscopic method requires less hospitalization and recuperation. EP and stone extraction are the methods of choice for managing common duct obstruction in high risk patients before cholecystectomy, for retained or reformed stones after cholecystectomy, and for papillary stenosis.