Summary
Long-term results after endoscopic sphincterotomy (EST) revealed disappearance or
improvement of symptoms in 92.0 %. The symptoms remained unchanged in 6.2 % and deteriorated
in only 1.8 %. X-ray follow-up studies showed concrement-free bile ducts in 85.2 %,
recurrent stones in 11.3 %, and a stenosis of EST in 3.5 %.
Satisfactory long-term results depend on the indication for EST. The results of EST
for choledocholithiasis are much better than for papillary stenosis (symptom-free
or improved = 91.7 %: 83.7 %, unchanged = 6.4 %: 14.3 %, deteriorated = 1.9 %: 2.0 %).
An EST-related stenosis was more than five times more frequent (16.8 %:2.9 %) in papillary
stenosis than choledocholithiasis.
A gallbladder in situ does not seem to be an additional risk factor after EST. Subsequent
cholecystectomy was performed in only 16.2 % (routinely and elective), and in only
2.0 % as an emergency procedure.
In approximately 50 % of the cases aerobilia and reflux, and in about 100 % bacteriocholia,
are observed after EST. When the free outflow of bile is ensured, it is not probable
that late secondary diseases will develop.
Key words:
Endoscopy - Sphincterotomy - Choledocholithiasis
