Endoscopic sphincterotomy for stones by experts is safe, even in younger patients with normal ducts.
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.
Cotton
P B
PB
Medical University of South Carolina, Charleston, USA.
Geenen
J E
JE
Sherman
S
S
Cunningham
J T
JT
Howell
D A
DA
Carr-Locke
D L
DL
Nickl
N J
NJ
Hawes
R H
RH
Lehman
G A
GA
Ferrari
A
A
Slivka
A
A
Lichtenstein
D R
DR
Baillie
J
J
Jowell
P S
PS
Lail
L M
LM
Evangelou
H
H
Bosco
J J
JJ
Hanson
B L
BL
Hoffman
B J
BJ
Rahaman
S M
SM
Male
R
R
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