Endoscopic Sphincteropapillotomy: An Analysis of 108 Cases

Abstract

Since 1976, endoscopic retrograde cholangiopancreatography (ERCP) has been done in 1,618 cases at Kwangju Christian Hospital in Kwangju, Korea. Between November 1981 and September 1984, endoscopic sphincteropapillotomy (EST) was performed on 108 patients. The results are as follows: Common bile duct stones were found in 98 of the patients (including 7 patients on whom T-tube cholangiography was done), ascaris in the common bile ducts of 6 of the patients, fibrotic stenosis of a periampullary choledochoduodenal fistula in 1 of the patients, and impacted stones in the ampulla of Vater in 3 of the patients (a percutaneous transhepatic cholangiography was also done on these 3 patients).In the case of 5 of the patients stones were extracted under direct vision, in the case of 39 of the patients stones passed in the stool, and in the case of 31 of the patients stone elimination was confirmed on repeated ERCP or T-tube cholangiography. In the case of 26 of the patients, small stones were removed, large stones remained and symptoms and laboratory findings showed improvement.As complications after EST, bleeding developed in 4 patients, acute pancreatitis with a pancreatic pseudocyst developed in 1 patient, and another patient died of sepsis following cholangitis.The overall success rate was 93.5%; morbidity rate, 5.6% and the mortality rate, 0.9%.