Long-term follow-up of endoscopic retrograde cholangiopancreatography sphincterotomy for patients with acquired immune deficiency syndrome papillary stenosis.
OBJECTIVE
To evaluate the long-term effects on biliary-type pain and changes in biochemical parameters in patients with AIDS-associated papillary stenosis who underwent endoscopic retrograde cholangiopancreatography (ERCP) sphincterotomy.


METHODS
Twenty-five consecutive patients were diagnosed by cholangiography with AIDS-associated papillary stenosis using standard criteria. Patients underwent ERCP sphincterotomy and were followed prospectively in the Gastrointestinal or Liver Clinics, San Francisco General Hospital, and by their primary physicians. Post-procedure data was prospectively collected by chart review or in-person or telephone interview, and analyzed using statistical software.


RESULTS
All patients presented with severe right upper quadrant and/or mid-epigastric abdominal pain and had marked elevations of serum alkaline phosphatase. Following ERCP sphincterotomy, pain scores decreased significantly for at least 9 months of follow-up. Serum alkaline phosphatase levels, however, remained essentially unchanged. Overall quality of life was difficult to assess, as patients suffered from other AIDS-associated debilitating diseases.


CONCLUSIONS
ERCP sphincterotomy, while not without risks, provided significant reduction in pain in patients with AIDS-associated papillary stenosis.
Cello
J P
JP
Department of Medicine, University of California San Francisco, USA.
Chan
M F
MF
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003137:Common Bile Duct Diseases / Q000209:etiology / Q000601:surgery; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009803:Sphincter of Oddi / Q000473:pathology / Q000601:surgery*; D016717:Sphincterotomy, Endoscopic / Q000379:methods*