The role of endoscopic biliary sphincterotomy for the treatment of type 1 biliary dysfunction (papillary stenosis) with or without biliary stones.
BACKGROUND
This study assesses the safety and effectiveness of endoscopic biliary sphincterotomy (ES) in the treatment of papillary stenosis (PS) with and without biliary stones.


METHODS
The records of all patients who had endoscopic retrograde cholangiopancreatography (2,689 patients) from January 1, 1991, to August 1, 2010, were reviewed. There were 117 patients with PS who had ES.


RESULTS
All patients had biliary pain, a dilated common bile duct (CBD) with a maximum diameter of 10 to 25 mm, and elevated liver function tests. There were 46 patients who had prior cholecystectomy of whom 20 patients had CBD stones. The remaining 71 patients had no prior biliary surgery; there were no biliary stones in 14 patients. All patients were symptom free after ES with or without CBD stone retrieval.


CONCLUSIONS
ES is the optimal treatment for PS in patients with or without biliary stones. ES eliminates pain, corrects CBD dilation, and restores LFTs to normal.
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA. Electronic address: csugawa@med.wayne.edu.
Choichi
C
Sugawa
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA.
Kristian L
KL
Brown
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA; Matsubara Clinic, Ichinomiya, Aichi, Japan.
Toshiki
T
Matsubara
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA.
Rebecca
R
Bachusz
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA; Department of Internal Medicine, Seiwa Memorial Hospital, Sapporo, Japan.
Hiromi
H
Ono
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA; Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Akiko
A
Chino
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA; Department of Endoscopy, Jikei University School of Medicine, Tokyo, Japan.
Takuji
T
Yamasaki
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA.
Charles E
CE
Lucas
D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003251:Constriction, Pathologic / Q000601:surgery; D004108:Dilatation, Pathologic / Q000601:surgery; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome
Biliary pain; Biliary stones; Endoscopic sphincterotomy; Papillary stenosis; Postcholecystectomy syndrome; Sphincter of Oddi dysfunction