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양영철(Young Cheol Yang),이상운(Sang Woon Lee),김제원(Je Weon Kim),김규순(Kyu Soon Kim),명재일(Jae Il Myeong),여향순(Hyang Soon Yeo),박홍배(Hong Bae Park) 대한내과학회 1986 대한내과학회지 Vol.30 No.6
N/A Since 1976, 1,856 cases of endoscopic retrograde cholangiopancreatography(ERCP) have been performed at Kwangju Christian Hospital, Kwangju, Korea. From December 1981 to August 1985, 138 cases of endoscopic sphincteropapillotomy(EST) were performed. The results are as following: 1) At ERCP, common bile duct stones were noted in 124 cases, ascaris in common bile duct in 10 cases, clonorchiaais in 3 cases, and fibrotic stenosis of a periampullary choledochoduodenal fistula in 1 case. Endoscopic sphincteropapillotomy (EST) was performed in these 138 cases. 2) In 5 cases stones were extracted under direct visualization, in 47 cases stones passed in stool, and in 43 cases stone extraction was confirmed at ERCP or T-tube cholangiography. In 30 cases, stones were not removed but symptoms showed improvement, 3) As complications following EST, bleeding developed in 4 patients, acute pancreatitis and a pancreatic pseudocyst developed in s patient due to an impacted stone and a patient died of sepsis following cholangitis. Recurrent cholangitis was noted in 5 patients and recurrent pancreatitis, in 2 patients. 4) The cases in which EST becomes difficult or fails easily include periampullary diverticula, fibrotic stenosis of ampulla of Vater, impacted stones in intrahepatic ducts or gallbladder, and so on. 5) With improved technical maneuver in EST, we could obviate bleeding and acute pancreatitis with a pancreatic pseudocyst due to an impacted stone and perform EST successfully in the cases with periampullary diverticula.