Follow-up 6 to 11 years after duodenoscopic sphincterotomy for stones in patients with prior cholecystectomy

One hundred sixty-three postcholecystectomy patients with retained or recurrent duct stones under-went successful duodenoscopic sphincterotomy and duct clearance between 1975 and 1980. Follow-up information was obtained on 148 patients in 1982, and on 115 of these in 1986 (at a mean of 8 yr). Fifteen patients (13%) were found to have had further biliary problems, but only 5 were known to have had sphincter stenosis and/or stones, and only 3 had not responded to endoscopic or conservative treatment. One had undergone choledochoduodenostomy for recurrent cholangitis (but continued to have problems), and 1 had died with jaundice, the precise cause of which was unknown. The third continued to have episodes of cholangitis requiring antibiotics despite the apparent lack of biliary obstruction. Bile showed significant bacterial contamination in 60% of 44 patients undergoing check endoscopy, but there was no correlation with symptoms. These long-term results are comparable with those of surgical procedures and justify the continuing use of endoscopic treatment for patients with duct stones.