Endoscopic sphincterotomy in acute gallstone pancreatitis: A prospective study of the late outcome

Objective: To describe the outcome after acute biliary pancreatitis in pati ents treated during the acute attack by endoscopic sphincterotomy without c holecystectomy. Design: Prospective observational study. Setting: University hospital, Norway. Subjects: 130 patients with gallstones and acute pancreatitis. In 62 patien ts with common bile duct stones the bile duct was cleared by sphincterotomy and stone extraction. The remaining. 68 patients had prophylactic sphincte rotomy. Cholecystectomy was not planned later. Main outcome measures: incidence of recurrent acute pancreatitis and need f or cholecystectomy. Results: 21 patients were dead or not available for the follow-up. Conseque ntly 109 patients were followed-up for a median of 39 months (range 23-62). One patient had recurrent pancreatitis. 20 patients had a cholecystectomy later for symptoms related to gallstone disease. Of the rest, 25 patients h ad moderate or mild gallstone-related symptoms. There was no difference in gallstone-related symptoms between those who had had stones in the bile duc t and those who had not. 63 patients had no symptoms related to gallstones. Conclusion: Endoscopic sphincterotomy during or immediately after acute gal lstone pancreatitis resulted in half the patients being free of symptoms du ring the next three years.