[Diseases of the major duodenal papilla as a cause of post-cholecystectomy syndrome].

Analysis of 460 patients suffering from the postcholecystectomy syndrome (PCS) revealed an abnormality in the major duodenal papilla (MDP) in 32.4% of them. The development of PCS in this group of patients was caused by coexistence of several pathological processes, which was established in 71% of patients with diseases of the MDP. The most frequently encountered conditions were papillitis (59.1%), cicatricial stenosis (56.3%), and stones (14.7%). Papillitis plays a double cause-effect role in PCS: as a primary chronic disease it may lead to cicatricial stenosis of the MDP, and, on the other hand, it may be a consequence of choledocholithiasis, cholangitis, and other diseases. Endoscopic papillosphincterotomy is the most effective method for the treatment of PCS caused by MDP diseases; it makes it possible to reduce significantly the number of repeated abdominal operations.