[Conservative management of XXXX following endoscopic sphincterotomy of papilla of Vater].

@entity1 @entity788 @entity295 @entity358 @entity2877 @entity1943 @entity204 @entity9317
BACKGROUND: Endoscopic sphincterotomy (ES) is an established procedure in treatment of diseases of the biliary tract; management of serious complications such as @entity9317 remains controversial. Because mortality is high if @entity295 is inadequately treated by no use of operative means, many surgeons advocate routine operative repair and drainage upon diagnosis. In surveys of large experiences, however, the majority @entity1 initially were treated non-surgically, and the majority recovered. OBJECTIVE: To evaluate our experience with non-surgical management in @entity1 with @entity9317 after ES. @entity1 AND METHODS: Retrospective chart review from January 1991 to December 2000 identified 12 instances of @entity9317 . We reviewed endoscopic cholangiopancreatography (ERCP) findings, diagnostic methods, time to diagnosis, methods of management, length of @entity1 stay, and outcome. RESULTS: Twelve @entity1 with diagnosis of @entity2877 (5) papillary stenoses (4) and @entity788 (3) had @entity9317 among 1,510 ES performed (0.79%). In all cases during ES, retroperitoneal air on fluoroscopic examinations was observed and diagnosis was made. One @entity1 was managed initially by surgery and @entity204 occurred due to @entity358 . Eleven @entity1 were treated conservatively with nasogastric aspiration, none by mouth intravenous fluids, antibiotics, and @entity1943 analog without mortality. Median length of stay was 6.7 days. CONCLUSIONS: @entity9317 after ES may be treated conservatively with success if identified during ES or early stage. Early diagnosis of @entity9317 is essential for optimum outcome.
