title: Endoscopic Sphincterotomy for Gallbladder Muddy Stones or Sludge in Patients With Papillary Disease: A Retrospective Study.
abstract: BACKGROUND
  The formation of gallbladder stones is associated with dysfunctional contraction and duodenal papilla diseases. However, endoscopic sphincterotomy can improve the contraction of the gallbladder and resolve duodenal papilla disease.
  
  
  OBJECTIVE
  The aim of the study was to assess the feasibility and effectiveness of endoscopic sphincterotomy in the treatment of muddy stones or sludge in the gallbladder during papillary disease.
  
  
  METHODS
  The clinical data of 53 patients with gallbladder muddy stones or sludge undergoing endoscopic sphincterotomy were retrospectively analyzed.
  
  
  RESULTS
  A total of 53 patients received successful endoscopic sphincterotomy with no serious complications. Sphincterotomy did not significantly lower resting gallbladder volume from 63.2±10.8 to 50.1±5.9 mL (P>0.05), but significantly increased gallbladder ejection fraction from 0.41±0.13 to 0.63±0.16 (P<0.01), as measured by the lipoid food test. The static liver and gallbladder imaging examination also showed an increase in gallbladder ejection fraction from 0.45±0.08 to 0.68±0.11 (P<0.01). In addition, the choledochus pressure reduced from 21.9±4.0 to 15.6±2.5 mm Hg, and the gallbladder muddy stones or sludge disappeared after endoscopic sphincterotomy. At the end of the follow-up period, there was no relapse of sludge or muddy stones in the gallbladder.
  
  
  CONCLUSIONS
  The formation of gallbladder muddy stones or sludge is associated with papilla disease. Endoscopic sphincterotomy can resolve papilla disease, decrease gallbladder bile stasis, improve gallbladder evacuation, and prevent the formation of gallbladder stones.
authors.affiliation: Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, Liaoning Province, P.R. China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhang
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Yang
authors.forename: Yue-Feng
authors.initials: YF
authors.lastname: Ma
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Zhang
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Shi
authors.forename: Jing-Yi
authors.initials: JY
authors.lastname: Li
authors.forename: Mei-Ju
authors.initials: MJ
authors.lastname: Lin
authors.forename: Chun-Chun
authors.initials: CC
authors.lastname: Qi
mesh_terms: D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology* / Q000601:surgery; D002681:China; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D015331:Cohort Studies; D003137:Common Bile Duct Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D016896:Treatment Outcome