PERCUTANEOUS TRANSHEPATIC PAPILLOTOMY

Abstract

Since August 1977, the new technique of endoscopic papillotomy (EPT), named PTPT : Percutaneous Transhepatic papillotomy, was successfully performed on patients who had percutaneous Transhepatic Catheterization of the bile duct (PTCD). The procedure of PTPT is as follows At first, PTCD is performed for the patient who has CBD stones complicating cholangitis. Then a papillotome is inserted into a PTCD catheter. And a duodenofiberscope is inserted via oral rout. Under duodenoscopic observation, papillotomy is performed by the papillotome previously inserted through the PTCD catheter. It is difficult to perform emergent EPT for a poor risk patient who has severe cholang-itis. And it is also difficult for a Billroth II gastrectmized patient. In such a case, PTPT is rather easier and safer to apply than ordinal EPT. We introduced the new technique of EPT named PTPT, and reported the exellency of PTPT in poor risk patients.