Abstract
In patients suspected of having functional disorders of the papilla it is often difficult
to establish the indications whether or not to perform endoscopic papillotomy (EP).
We report on thirty-two consecutive patients referred for endoscopic retrograde cholangiopancreatography
who all had longstanding biliary tract pain and episodes of liver enzyme elevation
indicating cholestasis. Further features were: 1) a dilated common bile duct (CBD)
after cholecystectomy (n = 11) or 2) a dilated CBD without or with larger (> cystic
duct diameter) gallbladder stones (n = 6) or 3) multiple small gallbladder stones,
with a normal or dilated CBD, in patients with signs of acute gallstone pancreatitis
or in whom elective cholecystectomy was not indicated (n = 15).
No CBD stones, organic obstruction or other disorders were found in these patients.
Without further diagnostic procedures, EP was routinely performed. The laboratory
(up to 3 months) and clinical findings (2 to 4 years follow up) showed improvement
in all patients undergoing EP. We conclude that immediate EP appears justified in
these selected patients.
