Long-Term Biliary Endoscopic Sphincterotomy Restenosis: Incidence, Endoscopic Management, and Complications of Retreatment

Abstract

Long-term restenosis is an important sequella of biliary endoscopic sphincterotomy. Repeat biliary endoscopic sphincterotomy is an effective treatment modality, but complications are not negligible.

Does endoscopic sphincterotomy reduce the risk of post‐endoscopic retrograde cholangiopancreatography pancreatitis after biliary stenting? A systematic review and meta‐analysis

“…This is very important because ES is associated with a higher complication rate, especially bleeding and perforation, which can be life‐threatening. In addition, there is a risk of papillary stenosis following ES . Although many endoscopists consider sphincterotomy to ease placement of a biliary stent, technical failure of stent placement without ES was not reported in any study included in our review .…”

Role of endoscopic papillary balloon dilation in patients with recurrent bile duct stones after endoscopic sphincterotomy

“…In addition, repeated sphincterotomy for treatment of papillary stenosis may result in a higher complication rate (16e23%). 21,35 In patients undergoing EPBD, no papillary stenosis was reported after 16 months of follow-up. 37 Additionally, EPLBD seems to be more effective and is associated with a lower rate of occurrence of papillary stenosis.…”

Determinants of long-term complications of endoscopic sphincterotomy are infections and high risk factors of bile duct and not sphincter of Oddi dysfunction

“…Recurrent choledocholithiasis is the most common longterm complication after EST, with the rate reported to be 4-24% [3,18]. In this study, 15 patients had recurrent choledocholithiasis and the recurrence rate was 10.8%.…”