Therapeutische Endoskopie.

Abstract

The most important promotor for the development of techniques for therapeutic endoscopy was diagnostic polypectomy. This review gives a survey of modern techniques applied in therapeutic endoscopy: 1) Polypectomy: on the basis of the author's experience all colorectal polyps should be removed by endoscopy. This recommendation is based on the findings that 80% of these polyps are of neoplastic origin. In the upper gastrointestinal tract endoscopic polypectomy is not so important since 75% of the polyps are of regenerative nature and only 2% appear to be primary malignant. 2) Control of bleeding: endoscopic control of bleeding is of high value as acute primary procedure. In the author's experience the modified use of electrocoagulation is preferable to the laser beam technique since it is less expensive and more mobile. 3) Endoscopic papillotomy and removal of stones: 10.9% complications were observed in 647 papillotomies, pancreatitis (2.6%) and bleeding (2.5%) being the most important. A mechanical lithotriptor is presented as a new device for lithotripsy in the common bile duct. So far 10 patients have been treated successfully by this technique. Other techniques like endoscopic prothetics or occlusion of the pancreatic duct are discussed including the author's preliminary experiences with these new techniques, that are still at experimental stage.