ENDOSCOPIC SPHINCTEROTOMY FOR STONES BY EXPERTS IS SAFE, EVEN IN YOUNGER PATIENTS WITH NORMAL DUCTS

Objective To provide current information on the risks of endoscopic sp hincterotomy for stone. Summary Background Data In recent years (since the popularity of laparoscopic cholecystectomy), endoscopic sphincter otomy has been used increasingly for the management of bile duct stone s in relatively young and healthy patients. The validity of this trend has been questioned using data on short-term complications derived fr om earlier decades that involved more elderly and high-risk patients. Methods Seven academic centers collected data prospectively using a co mmon database. Complications within 30 days of the procedures were doc umented by standard criteria. Results Of 1921 patients, 112 (5.8%) dev eloped complications; two thirds of these events were graded as mild ( <3 days in hospital). There was no evidence of increased risk in young er patients or in those with smaller bile ducts. There was only one se vere complication and there were no fatalities in 238 patients age <60 , with bile duct diameters of <9 mm. Conclusion Sphincterotomy for sto nes can be performed very safely by experienced endoscopists.