[Long term results after endoscopic sphincterotomy]

Abstract

A multicenter study of 25 centers covering 9041 endoscopic sphincterotomies showed that choledochal concrements still represent the main indication (83,9%). Circumscript papillary stenosis (10.64%) and papillary tumour(2.06%) are the next most frequent indications. Complications after endoscopic sphincterotomy may be expected in 7.55% of cases, somewhat more frequent after papillary stenoses than after choledochal concrements. The most frequent complication is haemorrhage, followed by pancreatitis, cholangitis in cases of choledochal concrements, and perforation. Mortality is around 1.12%. Late results after endoscopic sphincterotomy a satisfactory and concrement-free bile ducts are seen in 91.62%. Freedom of complaints or improvements of symptoms occur in 93.4%. Recurrent stones occur in 5.77%, restenoses were seen in 3.14%. Late results after endoscopic sphincterotomy ar worse in papillary stenosis than in choledocholithiasis. Mortality figures are twice as high and danger of perforation seems to be more frequent. Endoscopic sphincterotomy is done increasingly as an emergency measure.