We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Endoscopic Papillotomy A Plea for Rational Restraint

Arch Surg. 1979;114(9):991-992. doi:10.1001/archsurg.1979.01370330013001.
Text Size: A A A
Published online


Division of Oddi's sphincter may be accomplished under direct vision in the operating room or by electrocautery via the endoscope. Regardless of the technique employed, the procedure is associated with recognized complications, some of which result in death. The limitations and complications of sphincteroplasty are well known to the general surgeon. Endoscopists are beginning to appreciate the reality of this morbidity and mortality. We have recently had experience with two fatal and one nonfatal complications after endoscopic papillotomy. The reason for this procedure in two patients was "stenosis" of Vater's ampulla, and in the third patient calculi were present in both the common duct and the gallbladder. The deaths were due to pancreatitis in one patient and cholangitis in the other. The nonfatal complication was a duodenal perforation at Vater's ampulla. With any newtherapeutic procedure, excessive enthusiasm and the lack of proper guidelines may result in its overuse. A case


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.