FOLLOW-UP OF MORE THAN 10 YEARS AFTER ENDOSCOPIC SPHINCTEROTOMY FOR CHOLEDOCHOLITHIASIS IN YOUNG-PATIENTS

Background With the advent of laparoscopic cholecystectomy, the indica tions for endoscopic sphincterotomy (ES) have been extended to young p atients with choledocholithiasis. However, the long-term results of ES are largely unknown. Methods Between 1977 and 1986, 115 patients aged 60 years or less underwent ES for choledocholithiasis. Stone classifi cation, and early and long-term outcomes of ES were analysed retrospec tively. Results Early complications occurred in nine patients (7.8 per cent), but there were no deaths. ES and stone clearance were successf ul in 110 patients. Long-term information was available in 103 of the 110 patients, with a mean overall follow-up duration of 14.2 (range 10 .4-19.3) years. Ten patients (9.7 per cent) developed late complicatio ns, including stone recurrence and/or cholangitis (nine patients) and acute cholecystitis (one of 23 patients with the gallbladder in situ). The choledochal complication rate was somewhat higher in patients wit h calcium bilirubinate stones at ES (seven of 65 patients) than in tho se with cholesterol stones (two of 38 patients). Choledochal complicat ions were manageable endoscopically. Conclusion Approximately 10 per c ent of patients develop late complications. However, endoscopic retrea tment is safe and effective. ES is a reasonable method for treating ch oledocholithiasis, even in young patients.