Long-term efficacy of endoscopic papillo-sphincterotomy for common bile duct stones and benign papillary stenosis

Since its introduction in 1974, endoscopic sphincterotomy (EST) for common bile duct stones and benign papillary stenosis has become a well-established therapeutic procedure; however, at present, its long-term efficacy in comparison with that of biliary tract surgery remains a matter of debate. The long-term results observed during our follow-up (4 +/- 2 years) were satisfactory, revealing the disappearance of or an improvement in symptoms in 85.6% of subjects who had undergone EST. Recurrent stones were documented in 10.2% of patients; EST-related stenosis occurred in 3.8% of cases, approximately 3 times more frequently in papillary stenosis than in choledocholithiasis, likely due to the presence of a more extended incision in cases with common duct stones. A gallbladder in situ did not seem to be an additional risk factor after EST. As documented in other recent follow-up studies, the long-term efficacy of EST seems to be confirmed and comparable with that of biliary surgery.