Document Detail

Early endoscopic sphincterotomy in the management of acute gallstone pancreatitis in elderly patients.
MedLine Citation:
PMID:  2387954     Owner:  NLM     Status:  MEDLINE    
Eighteen elderly patients with acute attacks of gallstone pancreatitis underwent early endoscopic sphincterotomy of the papilla of Vater. Eleven patients were considered to be at high risk for surgery due to chronic cardiorespiratory or renal problems. The outcome of these patients was compared with that of 20 consecutive elderly patients with gallstone pancreatitis treated at the same time by means other than endoscopic sphincterotomy. Endoscopic sphincterotomy resulted in an immediate clinical improvement in all patients, except in one patient who developed transient cholangitis; there was no mortality. In contrast, there was one death (5%) and 20% morbidity in the controls. Mean hospitalization period was shorter in patients undergoing sphincterotomy (6 compared with 9.5 days), although the patients managed by sphincterotomy were initially more seriously ill than controls. Only two of the 11 high-risk patients underwent elective cholecystectomy; all others were well during a mean follow-up of 22 months. It is concluded that early endoscopic sphincterotomy is highly effective and safe in acute attacks of gallstone pancreatitis in elderly high-risk patients.
E Shemesh; A Czerniak; S Schneabaum; S Nass
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  38     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  1990 Aug 
Date Detail:
Created Date:  1990-09-27     Completed Date:  1990-09-27     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  893-6     Citation Subset:  IM    
Department of Gastroenterology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Israel.
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MeSH Terms
Acute Disease
Aged, 80 and over
Ampulla of Vater* / pathology
Cholangiopancreatography, Endoscopic Retrograde
Cholelithiasis / complications,  diagnosis,  therapy*
Common Bile Duct Diseases / complications,  diagnosis,  therapy
Endoscopy / adverse effects,  methods*
Pancreatitis / diagnosis,  etiology,  therapy*

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