title: Long-term follow-up after endoscopic management of retained and recurrent common duct stones.
abstract: Endoscopic sphincterotomy (EST) was attempted on 128 patients because of retained or recurrent common bile duct stones. The duct was cleared in 118 cases (92%). Early complications arose after 27 (16.5%) of 164 sphincterotomies, with haemorrhage most common. Emergency laparotomy was performed in four cases. There were four deaths within a month of EST, two of them directly attributable to EST. In seven of the 118 patients with successful EST late complications (stenosis and/or recurrent stone) appeared during a median follow-up of 57 (range 24-101) months (after less than 2 years in 6 cases). Restenosis and new stones could usually be endoscopically treated. Ascending cholangitis was not a problem, provided that the bile flow was unobstructed. EST is relatively safe, and must now be considered the procedure of choice for postcholecystectomy choledocholithiasis especially in elderly or high-risk patients. EST in young, fit patients is more controversial, and requires further detailed longitudinal analyses.
authors.affiliation: Department of Surgery, Central Hospital, Eskilstuna, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Kullman
authors.forename: K
authors.initials: K
authors.lastname: Borch
authors.forename: G
authors.initials: G
authors.lastname: Liedberg
mesh_terms: D000328:Adult; D000368:Aged; D002769:Cholelithiasis / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D013105:Sphincterotomy, Transduodenal / Q000009:adverse effects*