British experience with duodenoscopic sphincterotomy for removal of bile duct stones

Abstract

Duodenoscopic sphincterotomy is rapidly becoming popular in Britain. Representatives of 14 British centres met in January 1980 to discuss progress and problems with the technique. This report summarizes current experience, with particular reference to hazards. Duodenoscopic sphincterotomy is mainly being used in patients who have previously undergone cholecystectomy and who no longer have a T tube drain in place. Sphincterotomy was achieved in 87 per cent of 679 patients attempted, and the common duct was cleared of stones in 87 per cent of these. Immediate complications followed in 8.5 per cent; 1.6 per cent required urgent surgery and 7 patients (1 per cent) died. Centres with the greatest experience had better results and fewer complications. Those performing duodenoscopic sphincterotomy believe it to be a major advance in the management of high risk patients with common duct stones, after cholecystectomy. Its use remains controversial in high risk patients who still have gallbladders and in low risk patients after cholecystectomy; long term follow-up studies are essential.

Management of gallstone disease in the elderly

“…Although in this study the 2 endoscopists were one of each of the above, successful ERCP and duct clearance was lower than that quoted in the literature. 9,[20][21][22][23][24][25][26] Excluding failures, the complication rate in this small series of ERCP was minimal. All of the successfully treated patients, however, remained asymptomatic at the end of the study.…”

“…The 47 patients who had ERCP had a physiological score of 19 (range, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The procedure was successful in 40 (85.1%) patients.…”

Endoscopic sphincterotomy with or without cholecystectomy for choledocholithiasis in high‐risk surgical patients: a decision analysis

“…[1][2][3] Endoscopic stone extraction is successful in over 96% of patients [3][4][5] with a low procedure-related morbidity (5.8%) and mortality (0.2%). 3 Subsequent laparoscopic cholecystectomy (LC) is the standard treatment in those patients with concomitant gall-bladder stones.…”

Endoscopic Management of Bile Duct Stones at Riyadh Military Hospital: An Eight-Year Experience

“…Endoscopic sphincterotomy was a logical progression of ERCP, and is now the primary method of treating bile duct stones [9,10].…”