Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

STAIN STEPHEN C. M.D.; COHEN, HARTLEY M.D.; TSUISHOYSHA, MARK M.D.; DONOVAN, ARTHUR J. M.D.
Annals of Surgery: June 1991
SCIENTIFIC PAPERS: PDF Only
Buy

A prospective randomized trial was conducted of preoperative endoscopie sphincterotomy and surgery (ES&S) or surgery alone (SA) in 52 patients with cholecystolithiasis and choledocholithiasis that were candidates for elective surgery. After ES&S 65% of patients were stone free. Eighty-eight per cent of patients with SA were stone free after surgery (p < 0.05). Three patients in each group had residual stones at the completion of the operation. Five of these six had more than 20 common bile duct (CBD) stones. There was one episode of major hemorrhage in a patient in each group and no deaths. Costs were essentially equal for the individual patient with a successful ES as compared to SA. Societal costs of a program of preoperative endoscopie retrograde cholangiopancreatography and ES would be higher because of the cost of screening for patients with CBD stones. These results do not support preoperative ES as a technique for clearance of the CBD of stones on the basis of efficacy, morbidity rate, or cost.

© Lippincott-Raven Publishers.