Effect of endoscopic sphincterotomy on function of sphincter of Oddi and long-term complications

Abstract

Objective To investigate the effect of EST on function of sphincter of Oddi and on the long-term complications. Methods A total of 68 patients with common bile duct stones were recruited from January 2009 to January 2013 in The First People＇s Hospital of Hangzhou. All patients were under follow-up to observe the incidence of late complications after EST. Oddi sphincter manometry and bile bacterial culture were performed before EST and one year later. Results With the 13-36 months follow-up,the incidence of late complications was 16.9% （11/65）. The peak pressure and frequency of contraction of Oddi sphincter after EST were significantly lower than those before EST, but there were no significant differences between patients with complication and without （ P 〉 0. 05 ）. After EST, positive rate of biliary bacteria in patients with complications was much higher than that in patients without complications [70% （7/10）vs. 31.7% （13/41）, P = 0. 026], although there were no significant differences between them before EST [54. 5% （6/11 ） vs. 46. 3% （25/54） , P = 0. 618 ）. Logistic regression analysis showed that cholecystolithiasis, bile duct diameter （ 〉 1.5 cm）, number of stone （ 〉 3 ）, maximun diameter of stone （ 〉 20 mm）, large EST were independent risk factors for late complications of EST. Conclusion Importance should be attached to the late complications of EST with Oddi sphincter function declination, and biliary enteric reflux being the basic factor in late compilations after EST, which are also influenced by many risk factors. Key words: Sphincterotomy, endoscopic ; Sphincter of Oddi ; Manometry; Late complications