Endoscopic sphincterotomy in 1000 consecutive patients.
Between 1983 and 1988, endoscopic sphincterotomy was attempted on 1000 consecutive patients with a clinical diagnosis of bileduct stones in a centre with a policy to establish immediate bileduct drainage for retained stones. Endoscopic cholangiography was successful in 985 patients, of whom 782 had visible stones and 203 had a dilated bileduct but no visible stones. Endoscopic sphincterotomy was successful in 975 of these patients, with eventual bileduct clearance in 674 of 772 patients (87.3%) with visible stones; immediate bileduct drainage was achieved in 160 of the 161 patients (99%) in whom bileduct clearance failed at the first attempt. Overall, 771 of 797 patients (96.7%) with visible bileduct stones had successful bileduct clearance or drainage. Complications occurred in 6.9%, with a 30-day mortality rate of 1.2%, but procedure-related mortality was only 0.6%.
Vaira
D
D
Department of Gastroenterology, Middlesex Hospital, London.
D'Anna
L
L
Ainley
C
C
Dowsett
J
J
Williams
S
S
Baillie
J
J
Cairns
S
S
Croker
J
J
Salmon
P
P
Cotton
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002769:Cholelithiasis / Q000628:therapy*; D004322:Drainage; D004724:Endoscopy; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D013105:Sphincterotomy, Transduodenal / Q000009:adverse effects / Q000379:methods*