Long-term efficacy of endoscopic papillo-sphincterotomy for common bile duct stones and benign papillary stenosis.
Since its introduction in 1974, endoscopic sphincterotomy (EST) for common bile duct stones and benign papillary stenosis has become a well-established therapeutic procedure; however, at present, its long-term efficacy in comparison with that of biliary tract surgery remains a matter of debate. The long-term results observed during our follow-up (4 +/- 2 years) were satisfactory, revealing the disappearance of or an improvement in symptoms in 85.6% of subjects who had undergone EST. Recurrent stones were documented in 10.2% of patients; EST-related stenosis occurred in 3.8% of cases, approximately 3 times more frequently in papillary stenosis than in choledocholithiasis, likely due to the presence of a more extended incision in cases with common duct stones. A gallbladder in situ did not seem to be an additional risk factor after EST. As documented in other recent follow-up studies, the long-term efficacy of EST seems to be confirmed and comparable with that of biliary surgery.
Testoni
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PA
Institute of Internal Medicine, University of Milan, Italy.
Tittobello
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A
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D002763:Cholecystectomy; D002779:Cholestasis / Q000601:surgery*; D003251:Constriction, Pathologic; D005500:Follow-Up Studies; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D016717:Sphincterotomy, Endoscopic