Vnitr Lek 2005, 51(5):529-532

Urgent endoscopic papilosphincterotomy in individuals older than 70 years

P. Dítě1,*, Z. Papík2, M. Kunovská1, I. Novotný1, B. Kianička3, P. Piskač4, V. Zbořil1, M. Zavoral5
1 Interní gastroenterologická klinika FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Dítě, DrSc.
2 II. interní klinika Lékařské fakulty UK a FN, Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc.
3 Gastroenterologické oddělení FN u sv. Anny, Brno, přednosta prim. MUDr. Vladimír Bednařík
4 II. chirurgická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Jindřich Leypold, CSc.
5 II. interní oddělení, Klinika gastroenterologie a hepatologie 1. lékařské fakulty UK a ÚVN, Praha, přednosta doc. MUDr. Miroslav Zavoral, Ph.D.

Therapeutic endoscopy of acute pancreatobiliary conditions is represented in absolute majority of cases by endoscopic papilosphincterotomy performed after verification of finding in biliary duct and pancreatic duct by means of endoscopic retrograde cholangiopancreatography. Endoscopic operation is, of course, invasive performance that burdens the patients; therefore it is also accompanied with possible complications. In elderly individuals a risk factor of performance is undoubtedly polymorbidity, especially cardiovascular and bronchopulmonary diseases. In prospective study with individuals older than 70 years with acute cholangitis and acute biliary pancreatitis we evaluated performance safety and its effectivity as regards to the influence on the course of disease. We demonstrated that endoscopic papilosphincterotomy in mentioned conditions is safe performance, significantly favourably inflicting further development of the disease even in elderly patients. Nevertheless it is accepted that this performance in risk groups of individuals should be performed in the site, where the doctor-endoscopist has enough experience and the site is provided with the intensive medical care facility.

Keywords: pancreatitis; cholangitis; endoscopic papilotomy; elderly population

Received: September 15, 2004; Accepted: September 29, 2004; Published: May 1, 2005  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Dítě P, Papík Z, Kunovská M, Novotný I, Kianička B, Piskač P, et al.. Urgent endoscopic papilosphincterotomy in individuals older than 70 years. Vnitr Lek. 2005;51(5):529-532.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Bonder J, Nix GAJJ, de Ridder MAJ. Endoscopic papilotomy for common bile duct stones factors influencing the complication rate. Endoscopy 1994; 26: 209-216. Go to original source... Go to PubMed...
    2. Classen M, Demling L. Endoskopishe Sphinkerotomie der Papilla Vater und Steinextraktion aus dem Ductus choledocus. Dtsch Med Wochenschr 1974; 99: 469-477. Go to original source... Go to PubMed...
    3. Cotton PB, Wiliams CB. Practical Gastrointestinal Endoscopy. Oxford: Blackwell Scientific Publications 1992.
    4. Cotton PB, Lehmann G, Vennes J et al. Endoscopic sphincterotomy complication and their management an attempt at consensus. Gastrointest Endosc 1991; 10: 383-393. Go to original source... Go to PubMed...
    5. Cotton PB. Stents for stones: short-term good, long-term uncertain. Gastrointest Endosc 1995; 42: 272-274. Go to original source... Go to PubMed...
    6. Fan ST, Lai ESC, Mok FPT et al. Early treatment of acute biliary pancreatitis by endoscopic papilotomy. N Engl J Med 1993; 328: 228-232. Go to original source... Go to PubMed...
    7. Freeman ML, Nelson DR, Sherman S et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med 1996; 335: 909-918. Go to original source... Go to PubMed...
    8. Fölsch UR, Nitsche R, Ludtke R et al. and the German Study Group on Acute Biliary Pancreatitis. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. N Engl J Med 1997; 336: 237-242. Go to original source... Go to PubMed...
    9. Chopra KB, Peters RA, O'Toole PA et al. Randomized study of endoscopic biliary endoprosthesis versus duct clearance for bile duct stones in high risk patients. Lancet 1996; 348: 791-793. Go to original source... Go to PubMed...
    10. Lee JG, Leung JW. Endoscopic management of common bile duct stones. Gastrointest Endosc Clin North Am 1996; 6: 43-45. Go to original source...
    11. Neoptolemus JP, London NJ, James D et al. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due gallstones. Lancet 1998; ii: 979-983. Go to original source... Go to PubMed...
    12. Nowak A, Nowakowska-Dulawa E, Marck T et al. Final results of the prospective, randomized controled study on endoscopic sphincterotomy versus conventional management in acute biliary pancreatitis. Gastroenterology 1995; 108: A380. Go to original source...
    13. Ponsky JL. Endoscopic management of common bile duct stones. World J Sug 1992; 16: 1060-1065. Go to original source... Go to PubMed...
    14. Seitz U, Bapaye A, Bohnacker S et al. Adavances in therapeutic endoscopic treatment of common bile duct stones. World J Surg 1998; 22: 1133-1144. Go to original source... Go to PubMed...
    15. Skála I, Pirk F, Skála J. Endoskopické léčebné výkony na Vaterské papile a žlučovodech. Novinky v medicíně. Praha: Avicenum 1990.
    16. Van Steenbergen W, Pelemans W, Fevery J. Endoscopic biliary endoprosthesis in elderly patients with large bile duct stones. A long-term follow-up. J Am Geriatric Soc 1992; 40: 57-60. Go to original source... Go to PubMed...
    17. Vavrečka A. Diagnostická a liečebná endoskopia žlučových ciest a pankreasu. Martin: Osvieta 1983.

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.