Læknablaðið - 15.02.1997, Qupperneq 43

LÆKNABLAÐIÐ 1997; 83
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1,5% allra hringvöðvaskurða en lýst er 2,9%
tíðni (15).
Afdrifaríkasti aukakvillinn í þessu uppgjöri
var bráð brisbólga og létust þrír sjúklingar af
þeim sex er fengu hana. Tveir sjúklingar létust
eftir aðgerðir en einn eftir rannsókn þar sem
engin aðgerð var framkvæmd. Dánartíðni án
aðgerðar er um 0,2% (16) og eftir hringvöðva-
skurð 0,8-3,6% (18,19). Niðurstaða þessarar
rannsóknar er ásættanleg, 0,5% heildardánar-
tíðni, 0,4% eftir greiningarrannsókn og 0,8%
eftir hringvöðvaskurð. Þessar niðurstöður
sýna að holsjárröntgenmyndun af gallvegum
og brisgangi er rannsókn sem hefur í för með
sér áhættu á aukaverkunum, einkum bris-
bólgu. Fylgikvillum fækkar með bættri tækni
og reynslu þeirra sem framkvæma rannsókn-
irnar þó vafasamt sé að algjörlega takist að
koma í veg fyrir aukakvilla.
Þakkir
Vísindasjóður styrkti rannsóknina.
HEIMILDIR
1. McCune WS, Shorb PE, Moscovitz H. Endoscopic can-
nulation of the ampulla of Vater: a preliminary report.
Ann Surg 1968; 167: 752-6.
2. Kawai K, Akasaka Y. Murakami K, Tada M, Kohii Y,
Nakajima M. Endoscopic sphincterotomy of the ampul-
la of Vater, Gastrointest Endosc 1974; 20: 148-51.
3. Witzel L, Hacki W, Halter F, Simple method for remov-
al of gallstones after duodenoscopic sphincterotomy. N
Engl J Med 1977; 296: 1536-7.
4. Theodórs Á, Hrafnkelsson H. Holsjárröntgenmyndun
af gallgöngum og brispípu. Rannsóknir og aðgerðir
framkvæmdar á Borgarspítalanum 1981-1990. Lækna-
biaðið 1992; 78: 221-7.
5. Gilinsky NH, Bornman PC, Girdwood AH, Marks IN.
Diagnostic yield of endoscopic retrograde cholangio-
pancreatography in carcinoma of the pancreas. Br J Surg
1986; 73: 539-43.
6. Nix GAJJ, Schmitz PIM, Wilson JHP. Carcinoma of the
head of pancreas. Therapeutic implications of endoscop-
ic retrograde cholangiopancreatography findings. Gas-
troenterology 1984; 87 : 37-43.
7. Kullman E, Borch K, Tarpila E, Liedberg G. Endoscop-
ic retrograd cholangiopancreatography (ERCP) in pa-
tients with jaundice and suspected biliary obstruction.
Acta Chir Scand 1984; 150: 657-63.
8. Ruddei WSJ, Lintott DJ, Axon ATR. The diagnostic
yield of ERCP in investigation of unexplained abdom-
inal pain. Br J Surg 1983; 70: 74-5.
9. Health and public policy committee, American college
of physicians; Philadelphia Pennsylvania. Clinical com-
petence in diagnostic endoscopic retrograde cholangio-
pancreatography. Ann Int Med 1988; 108: 142—4.
10. Van Der Spuy S. Endoscopic retrograde cholangiopan-
creatography and endoscopic sphincterotomy in the
management of suspected gallstone pancreatitis. S Afr
Med J 1991; 79: 16-8.
11. Steward ET, Vennes JA, Geenen JE. Atlas of endo-
scopic retrograde cholangiopancreatography. St. Louis:
CV Mosby, 1977.
12. Hall RI, Ingoldby CJH, Denyer ME. Periampullary di-
verticula predispose to primary rather than secondary
stones in the common bile duct. Endoscopy 1990; 22:
127-8.
13. Tulassay Z. Endoscopic Retrograde Cholangiopancrea-
tography in Mirizzi syndrome. Am J Gastroenterol 1987;
82: 391.
14. Agha FP. Williams KD. Pancreas divisum: incidence,
detection, and clinical significance. Am J Gastroenterol
1987; 82; 315-20
15. Cotton PB, Vallon AG. British experience with duode-
noscopic sphincterotomy for removal of bile duct stones.
Br J Surg 1981; 68: 373-5.
16. Slivka A, Carr-Locke DL. Therapeutic biliary endosco-
py. Endoscopy 1992; 24: 100-19.
17. Scheeres DE, Simon I, Ponsky JL. Endoscopic retro-
grade cholangiopancreatography in general surgery
practice. Am Surg 1990; 56: 185—91.
18. Bilbao MK, Dotter CT, Lee TG, Katon RM. Complica-
tions of endoscopic retrograde cholangiopancreatogra-
phy (ERCP). Gastroenterology 1976; 70: 314-20.
19. Lenriot JP, Le-Neel JC, Hay JM, Jaeck D, Millat B,
Fagniez PL. Retrograde cholangiopancreatography and
endoscopic sphincterotomy for biliary lithiasis. Gas-
troenterol Clin Biol 1993; 17: 244-50.
20. Viceconte G, Viceconte GW, Pietropaolo V, Montori
A. Endoscopic sphincterotomy: indications and results.
Br J Surg 1981; 68: 376-80.
21. Soergel KH. Acute pancreatitis. In: Sleisenger and
Fordtran. Gastrointestinal disease. 5th ed. Vol. 2. Phila-
delphia: W.B. Saunders Company, 1993: 1629-53.
22. Cotton PB. Towards safer endoscopic retrograde cho-
langiopancreatography (ERCP). Gut 1994; 35: 284.
23. Stanten R, Frey CF. Pancreatitis after endoscopic retro-
grade cholangiopancreatography. An underreported
disease whose severity is often unappreciated. Arch
Surg 1990; 125: 1032-4.
24. Kasugai T, KunoN, Kobayashi S, Hattori K. Endoscop-
ic pancreatocholangiography. Gastroenterology 1972;
63: 217-26.
25. Yoshimoto S, Ohnishi R, Doi S, Kawai K. Endoscopic
retrograde pancreatic parenchymograhpy. Radiology
1981; 141: 219-22.
26. Lifton L, Brooks C, Rosson R, Scheig R. The effect of
upper gastrointestinal endoscopy on serum amylase
(abs). Gastroenterology 1975; 68: 936.
27. Novello P, Hagege H, Ducreux M, Buffet C, Choury A,
Fritsch J, et al. Septicemias after endoscopic retrograde
cholangiopancreatography. Gastroenterol Clin Biol
1993; 17: 897-902.