title: Gallbladder function and recurrent stones of the biliary tract in patients after endoscopic sphincterotomy.
abstract: BACKGROUND
  Change in gallbladder function may occur in patients with an intact gallbladder after endoscopic sphincterotomy (EST). This study was designed to evaluate the factors influencing gallbladder filling after EST and the correlation between gallbladder function and stone recurrence.
  
  
  METHODS
  Sixty Chinese patients with symptomatic choledocholithiasis and an intact gallbladder received EST to clear the bile ducts. They were further investigated with sphincter of Oddi manometry (SOM), quantitative cholescintigraphy (QC), and long-term clinical follow-up.
  
  
  RESULTS
  Fifty-six of the 60 patients in the study group were confirmed to have a loss of sphincteric function by SOM. QC showed normal gallbladder filling in 35 of these patients and delayed or non-filling in 21 patients. A significantly higher incidence of normal gallbladder filling occurred in patients with juxtapapillary diverticulum than in those without (P < 0.02), but preexisting cholecystolithiasis had no effect on it. During the follow-up period (median, 32 months: range, 9-54 months) 10 of 56 patients developed recurrent choledocholithiasis. There was no correlation between the status of gallbladder filling, preexisting cholecystolithiasis, and recurrent stones, but 9 of the 10 patients with recurrent stones had a juxtapapillary diverticulum. Repeated endoscopic treatment was satisfactory in eight patients, and only two patients received cholecystectomy.
  
  
  CONCLUSIONS
  EST does not alter gallbladder function in most patients. Juxtapapillary diverticulum may facilitate gallbladder filling after EST, but it is also a possible factor for recurrent choledocholithiasis.
authors.affiliation: Division of Gastroenterology, Veterans General Hospital-Kaohsiung, Taiwan.
authors.forename: K H
authors.initials: KH
authors.lastname: Lai
authors.forename: N J
authors.initials: NJ
authors.lastname: Peng
authors.forename: J S
authors.initials: JS
authors.lastname: Cheng
authors.forename: G H
authors.initials: GH
authors.lastname: Lo
authors.forename: E M
authors.initials: EM
authors.lastname: Wang
authors.forename: N M
authors.initials: NM
authors.lastname: Wang
authors.forename: R L
authors.initials: RL
authors.lastname: Huang
authors.forename: C F
authors.initials: CF
authors.lastname: Chang
authors.forename: C K
authors.initials: CK
authors.lastname: Lin
authors.forename: S M
authors.initials: SM
authors.lastname: Chen
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016473:Gallbladder Emptying / Q000502:physiology*; D042882:Gallstones / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007098:Imino Acids; D008297:Male; D008365:Manometry; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012008:Recurrence; D009803:Sphincter of Oddi / Q000503:physiopathology; D016717:Sphincterotomy, Endoscopic; D019784:Technetium Tc 99m Diethyl-iminodiacetic Acid; D013997:Time Factors
chemical_list: D007098:Imino Acids; D015609:Organotechnetium Compounds; D019784:Technetium Tc 99m Diethyl-iminodiacetic Acid