ENDOSCOPIC SPHINCTEROTOMY FOR COMMON BILE-DUCT STONES IN YOUNGER PATIENTS

Background and study aims: Most follow-up studies of patients with com mon bile duct stones treated with endoscopic sphincterotomy include ol der patients. Therefore, the aim of the present study was to do a medi um-term follow-up of patients under the age of 60 years, who underwent endoscopic sphincterotomy and removal of common bile duct stones. Met hods: Eighty-six (68 women) consecutive patients less than 60 years of age (median age 47 years) were evaluated. The median observation time after endoscopic sphincterotomy was 27.1 months. Complete follow-up w as accomplished in 80 patients. Results: Twenty-five patients had unde rgone cholecystectomy prior to the endoscopic sphincterotomy. Sixty-on e patients were discharged after endoscopic sphincterotomy with gallbl adder left in situ. Cholecystectomy was not needed in 27 patients, of whom 23 had gallbladder stones. In 13 of 61 patients subsequent electi ve cholecystectomy was planned at the time of endoscopic sphincterotom y. Recurrent attacks of biliary colic required elective cholecystectom y in another thirteen patients. Acute cholecystectomy was undertaken i n eight patients due to acute cholecystitis (n = 4) or biliary colic ( n = 4). Seven of eight acute cholecystectomies were performed within 1 52 days after the endoscopic sphincterotomy. The overall median time u ntil cholecystectomy was 51 days (25-75 percentiles, 23-103 days). Con clusions: One third of the patients had been cholecystectomized prior to the endoscopic treatment of their common bile duct stones. Nearly h alf of the young patients discharged after endoscopic sphincterotomy f or common bile duct stones with the gallbladder left in situ at the ti me of endoscopic sphincterotomy managed well without any need for chol ecystectomy.