BILIARY SYMPTOMS AND COMPLICATIONS MORE THAN 8 YEARS AFTER ENDOSCOPICSPHINCTEROTOMY FOR CHOLEDOCHOLITHIASIS

Background & Aims: Although long-term results of endoscopic sphinctero tomy (ES) have been poorly estimated, extended indications of ES have been proposed, especially in young patients. The aim of this study was to assess late biliary complications of ES. Methods: Between 1981 and 1986, 169 patients younger than age 70 (55 +/- 11.8 years; range, 24- 70 years; male-female sex ratio, 0.55) underwent ES for choledocholith iasis. One hundred fifteen patients (68%) underwent cholecystectomy. L ong-term data were obtained retrospectively from the patients and gene ral practitioners. Results: Information was obtained for 156 patients, 2 of whom died within 1 month (one ES-related death). The mean follow -up for 154 patients was 9.6 +/- 3.3 years (range, 8-13 years); 138 pa tients had no biliary symptoms. During follow-up, 16 patients experien ced biliary symptoms; 2 of these patients underwent elective cholecyst ectomy, 3 had malignant strictures, 1 had a complicated cirrhosis, and 1 had a benign stricture related to the previous cholecystectomy. Nin e patients developed potentially ES-related biliary symptoms. Second e ndoscopic exploration showed papillary stenosis in 3 patients (with st ones in 2 patients) and recurrent bile duct stones in 3 others. Two pa tients had sine materia cholangitis, and 1 patient developed liver abs cesses. Conclusions: Long-term ES-related complications seem to be rar e. ES could reasonably be included in management strategies of choledo cholithiasis, even in young patients.