Endoscopic sphincterotomy: preliminary experience at a university hospital.

ABSTRACT

Endoscopic sphincterotomy (ES) was attempted in 38 patients with biliary calculi. There were 21 patients (55.3%) with common bile duct (CBD) stones following cholecystectomy, 14 patients (36.8%) with intact gall bladder and 3 patients with retained CBD stones along with T tube in the early post-operative period. Endoscopic sphincterotomy was possible in all but one patient and duct clearance was attained in 34 (89.4%) patients. Spontaneous clearance of calculi occurred in 31 (81.6%) patients while 3 patients required instrumental extraction. Four patients failed to clear stones and required surgical intervention. Complications occurred in 4 (10.5%) patients--haemorrhage in two, pancreatitis and cholangitis in one each. One patient died of bleeding on the 4th day following ES while hemostasis was achieved in other after two units of blood. Other complications were managed conservatively without any mortality. Endoscopic sphincterotomy appears to be a simple, effective and safe therapeutic modality for the management of biliary calculi.