Long-term symptoms following endoscopic sphincterotomy for common bile duct stones

Endoscopic sphincterotomy (ES) has an important role in the management of biliary stones. However, the long-term effects of free duodenobiliary reflux are not established, and it may lead to low-grade morbidity.

We used a questionnaire survey to assess the prevalence of symptoms of biliary disorder in patients who had undergone endoscopic retrograde cholangio pancreatography (ERCP) and ES under the care of a single surgeon (R.J.R.G) between November 1993 and May 1998.

ES was carried out on 136 patients during this period. Current addresses were available for 94 patients, and 54 of them (57%) responded. Patients were surveyed a mean of 43 months after ES. Only 42.1% of patients denied having any symptoms. Nausea and pale stools were reported by 28% and 26% of patients, respectively, and nearly one-fifth of patients had symptoms suggestive of cholangitis. In addition, 18.5% of patients experienced one or more symptoms frequently.

Severe long-term symptoms are uncommon following ES; however, a significant minority of patients do suffer occasional symptoms that suggest biliary dysfunction.