Background: Endoscopic sphincterotomy (ES) has an important role in the management of biliary stones. However, the long-term effects of free duodenobiliary reflux are not established, and it may lead to low-grade morbidity. Methods: We used a questionnaire survey to assess the prevalence of symptoms of biliary disorder in patients who had undergone endoscopic retrograde cholangio pancreatography (ERCP) and ES under the care of a single surgeon (R.J.R.G) between November 1993 and May 1998. Results: ES was carried out on 136 patients during this period. Current addresses were available for 94 patients, and 54 of them (57%) responded. Patients were surveyed a mean of 43 months after ES. Only 42.1% of patients denied having any symptoms. Nausea and pale stools were reported by 28% and 26% of patients, respectively, and nearly one-fifth of patients had symptoms suggestive of cholangitis. In addition, 18.5% of patients experienced one or more symptoms frequently. Conclusion: Severe long-term symptoms are uncommon following ES; however, a significant minority of patients do suffer occasional symptoms that suggest biliary dysfunction.
Endoscopy Endoscopic retrograde cholangiopancreatography (ERCP) Common bile duct stones Endoscopic sphincterotomy Late complications
This is a preview of subscription content, log in to check access.
Classen, ML, Demling, L 1974Endoskopische Sphinkterotomie der Papilla Vateri and Steinextraktion aus dem Ductus choledochus.Dtsch Med Wochen schr99496497Google Scholar
Coppola, R, Ricciona, ME, Ciletti, S, Cosentino, L, Coco, C, Magistrelli, P, Picciocchi, A 1997Analysis of complications of endoscopic sphincterotomy for biliary stones in a consecutive series of 546 patients.Surg Endosc11129132CrossRefPubMedGoogle Scholar
Cotton, PB 1984Endoscopic management of bile duct stones: apples and oranges
Cotton, PB, Lehman, G, Vennes, J, Gennen, JE, Russel, RCG, Meyers, WC, Liguory, C, Nickl, N 1991Endoscopic sphincterotomy complications and their management: an attempt at consensus.Gastrointest Endosc37383393PubMedGoogle Scholar
Escourrou, J, Cordova, JA, Lazorthes, F, Frexinos, J, Ribet, A 1984Early and late complications after endoscopic sphincterotomy for biliary lithiasis with and without the gallbladder ‘in situ’.Gut25598602PubMedGoogle Scholar
Geenen, JE, Toouli, J, Hogan, WJ, Dodds, WJ, Stewart, ET, Maverlis, P, Riedel, D, Venu, R 1984Endoscopic sphincterotomy: follow up evaluation of effects on the sphincter of Oddi.Gastroenterology87754758PubMedGoogle Scholar
Goodall, RJR 1985Bleeding after endoscopic sphincterotomy.Ann R Coll Surg Engl678788PubMedGoogle Scholar
Greenfield, C, Cleland, P, Dick, R, Masters, S, Somerfield, JA, Sherlock, S 1985Biliary sequelae of endoscopic sphincterotomy.Postgrad Med J61213215PubMedGoogle Scholar
Hawes, RH, Cotton, PB, Vallon, AG 1990Follow-up 6 to 11 years after duodenoscopic sphincterotomy for stones in patients with prior cholecystectomy.Gastroenterology9810081012PubMedGoogle Scholar
Ikeda, S, Tanaka, M, Matsumoto, S, Yoshimoto, H, Itoh, H 1988Endoscopic sphincterotomy: long-term results in 408 patients with complete follow-up.Endoscopy201317PubMedGoogle Scholar
Jacobson, O, Matzen, P 1987Long term follow-up study of patients after endoscopic sphincterotomy for choledocholithiasis.Scand J Gastroenterol22903906PubMedGoogle Scholar
Kawai, KY, Alasaka, K, Murakami, K, Tada, M, Koli, Y 1974Endoscopic sphincterotomy of the ampulla of Vater.Gastrointest Endosc20148151PubMedGoogle Scholar
Riemann, JR, Lux, G, Forster, P 1983Long-term results after endoscopic papillotomy.Endoscopy15165168PubMedGoogle Scholar