title: Endoscopic sphincterotomy for stones by experts is safe, even in younger patients with normal ducts.
abstract: OBJECTIVE
  To provide current information on the risks of endoscopic sphincterotomy for stone.
  
  
  BACKGROUND
  In recent years (since the popularity of laparoscopic cholecystectomy), endoscopic sphincterotomy has been used increasingly for the management of bile duct stones in relatively young and healthy patients. The validity of this trend has been questioned using data on short-term complications derived from earlier decades that involved more elderly and high-risk patients.
  
  
  METHODS
  Seven academic centers collected data prospectively using a common database. Complications within 30 days of the procedures were documented by standard criteria.
  
  
  RESULTS
  Of 1921 patients, 112 (5.8%) developed complications; two thirds of these events were graded as mild (<3 days in hospital). There was no evidence of increased risk in younger patients or in those with smaller bile ducts. There was only one severe complication and there were no fatalities in 238 patients age <60, with bile duct diameters of <9 mm.
  
  
  CONCLUSIONS
  Sphincterotomy for stones can be performed very safely by experienced endoscopists.
authors.affiliation: Medical University of South Carolina, Charleston, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: Cotton
authors.forename: J E
authors.initials: JE
authors.lastname: Geenen
authors.forename: S
authors.initials: S
authors.lastname: Sherman
authors.forename: J T
authors.initials: JT
authors.lastname: Cunningham
authors.forename: D A
authors.initials: DA
authors.lastname: Howell
authors.forename: D L
authors.initials: DL
authors.lastname: Carr-Locke
authors.forename: N J
authors.initials: NJ
authors.lastname: Nickl
authors.forename: R H
authors.initials: RH
authors.lastname: Hawes
authors.forename: G A
authors.initials: GA
authors.lastname: Lehman
authors.forename: A
authors.initials: A
authors.lastname: Ferrari
authors.forename: A
authors.initials: A
authors.lastname: Slivka
authors.forename: D R
authors.initials: DR
authors.lastname: Lichtenstein
authors.forename: J
authors.initials: J
authors.lastname: Baillie
authors.forename: P S
authors.initials: PS
authors.lastname: Jowell
authors.forename: L M
authors.initials: LM
authors.lastname: Lail
authors.forename: H
authors.initials: H
authors.lastname: Evangelou
authors.forename: J J
authors.initials: JJ
authors.lastname: Bosco
authors.forename: B L
authors.initials: BL
authors.lastname: Hanson
authors.forename: B J
authors.initials: BJ
authors.lastname: Hoffman
authors.forename: S M
authors.initials: SM
authors.lastname: Rahaman
authors.forename: R
authors.initials: R
authors.lastname: Male
mesh_terms: D000367:Age Factors; D000368:Aged; D001652:Bile Ducts / Q000473:pathology; D002769:Cholelithiasis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects