title: Complications of endoscopic sphincterotomy: results from a single tertiary referral center.
abstract: OBJECTIVE
  Complications of endoscopic sphincterotomy (ES) have been assessed in recent multicenter studies. The aim of this series was to report and identify risk factors for complications of ES at a single tertiary referral center.
  
  
  METHODS
  Between 1996 and 2000, 1159 consecutive endoscopic retrograde cholangiopancreatographies (ERCP) procedures were performed and their related complications were assessed. A total of 658 patients (57 %) underwent ES. All the clinical, radiological and biological data were carefully recorded within the 30 days following the procedure. Multivariate analysis was performed using a stepwise logistic model.
  
  
  RESULTS
  The morbidity rate for ES was 7.7 %, being moderate to severe in 5 %. Morbidity included acute pancreatitis (3.5 %), perforations (1.8 %), sepsis (1.2 %) and bleeding (1.2 %). The 30-day mortality was 0.9 %. In the 1159 ERCP procedures, 231 patients underwent precut papillotomy (20 %) followed by sphincterotomy in 174 cases. Using logistic regression analysis, the risk factors for ES were precut papillotomy (relative risk, RR 2.76), confidence interval, (CI 1.39 - 5.49) and the presence of sphincter of Oddi dysfunction (RR, 7.72, CI 3.2 - 18.4).
  
  
  CONCLUSIONS
  In this single-center series, we found a complication rate of ES in about 7 %, comparable to that in multicenter series. Precut papillotomy and sphincter of Oddi dysfunction were the main independent risk factors for ES.
authors.affiliation: Department of Gastroenterology, Hôpital Nord, Marseille, France. mbarthet@mail.ap-hm.fr
authors.forename: M
authors.initials: M
authors.lastname: Barthet
authors.forename: N
authors.initials: N
authors.lastname: Lesavre
authors.forename: A
authors.initials: A
authors.lastname: Desjeux
authors.forename: M
authors.initials: M
authors.lastname: Gasmi
authors.forename: P
authors.initials: P
authors.lastname: Berthezene
authors.forename: S
authors.initials: S
authors.lastname: Berdah
authors.forename: X
authors.initials: X
authors.lastname: Viviand
authors.forename: J C
authors.initials: JC
authors.lastname: Grimaud
mesh_terms: D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000293:injuries; D010182:Pancreatic Diseases / Q000209:etiology; D010195:Pancreatitis / Q000209:etiology; D011183:Postoperative Complications; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects*