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In group 1 endoscopic stone clearance was successful in 35 of 39 patients. Thirteen patients subsequently had cholecystectomy with (n = 7) or without (n = 6) biliary symptoms and one had a cholecystostomy for acute cholecystitis. Two patients have had mild biliary colic or pancreatitis. Two patients died from gallbladder carcinoma after 9 days and 18 months. In group 2 bile duct stones were cleared surgically in 37 of 41 patients. Late complications occurred in two patients (incisional hernia and recurrent stone). One patient with gallbladder carcinoma was cured and another died after 16 months. Early major and minor complications occurred in three and four respectively of 39 patients in group 1, and in three and six respectively of 41 patients in group 2. There were no deaths. During follow-up the total morbidity rate reached 28 per cent (11 of 39) and 5 per cent (two of 41) (P = 0.005) and the non-biliary related mortality rate was 31 per cent (12 of 39) and 10 per cent (four of 41) (P = 0.02) in groups 1 and 2 respectively. Nine patients in group 1 and two in group 2 died from heart disease (P = 0.02). Total hospital stay was 2\u201342 (median 13) days and 6\u201336 (median 16) days in groups 1 and 2 respectively (P not significant). Endoscopic and surgical treatment of bile duct calculi in middle-aged and elderly patients with gallbladder in situ are equally effective in the long term. However, the significantly increased mortality rate from heart disease in patients treated endoscopically compared with those treated surgically might speak in favour of operation.<\/jats:p>","DOI":"10.1002\/bjs.1800821121","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T16:37:45Z","timestamp":1172939865000},"page":"1516-1521","source":"Crossref","is-referenced-by-count":88,"title":["Long-term follow-up of a prospective randomized study of endoscopic\n                    <i>versus<\/i>\n                    surgical treatment of bile duct calculi in patients with gallbladder\n                    <i>in situ<\/i>"],"prefix":"10.1093","volume":"82","author":[{"given":"L-E","family":"Hammarstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Lund , Lund,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Holmin","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Lund , Lund,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Stridbeck","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, University of Lund , Lund,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Ihse","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Lund , Lund,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1995,11,1]]},"reference":[{"key":"2024092815134874400_bib1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1002\/bjs.1800680602","article-title":"British experience with duodenoscopic sphincterotomy for removal of bile duct stones","volume":"68","author":"Cotton","year":"1981","journal-title":"Br J Surg"},{"key":"2024092815134874400_bib2","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/BF01563686","article-title":"Results of endoscopic papillotomy: a collective experience from nine endoscopic centers in West Germany","volume":"2","author":"Reiter","year":"1978","journal-title":"World J Surg"},{"key":"2024092815134874400_bib3","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1136\/gut.25.6.598","article-title":"Early and late complications after endoscopic sphincterotomy for biliary lithiasis with and without the gall bladder \u2018in situ\u2019","volume":"25","author":"Escourrou","year":"1984","journal-title":"Gut"},{"key":"2024092815134874400_bib4","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/S0039-6109(16)42832-X","article-title":"Endoscopic management of choledocholithiasis","volume":"62","author":"Safrany","year":"1982","journal-title":"Surg Clin North Am"},{"key":"2024092815134874400_bib5","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1055\/s-0028-1098339","article-title":"Five years experience of endoscopic sphincterotomy in Japan: a collective study from 25 centres","volume":"11","author":"Nakajima","year":"1979","journal-title":"Endoscopy"},{"key":"2024092815134874400_bib6","first-page":"616","article-title":"Mortality following gallbladder surgery: a study of 3257 cholecystectomies","volume":"71","author":"Boquist","year":"1972","journal-title":"Surgery"},{"key":"2024092815134874400_bib7","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/0002-9610(89)90246-8","article-title":"Cholecystectomy: the gold standard","volume":"158","author":"McSherry","year":"1989","journal-title":"Am J Surg"},{"key":"2024092815134874400_bib8","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/00000658-198003000-00003","article-title":"The incidence and causes of death following surgery for nonmalignant biliary tract disease","volume":"191","author":"McSherry","year":"1980","journal-title":"Ann Surg"},{"key":"2024092815134874400_bib9","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1001\/archsurg.1969.01340100060006","article-title":"Biliary tract operations. 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