Late Complications following Endoscopic Sphincterotomy for Choledocholithiasis: A Swedish Population-Based Study

Area of Science:

• Gastroenterology
• Hepatology
• Endoscopic Procedures

Background:

• Endoscopic sphincterotomy (ES) is a common procedure for treating common bile duct stones (CBDS).
• Long-term complications following ES for CBDS require further investigation to optimize patient care.
• Assessing the risk of long-term adverse events is crucial for understanding the overall safety profile of ES.

Purpose of the Study:

• To evaluate the risk of long-term complications after endoscopic sphincterotomy (ES) for common bile duct stones (CBDS).
• To compare the morbidity and mortality rates of patients who underwent ES with a matched population cohort.
• To identify specific complications associated with ES for CBDS.

Main Methods:

• A cohort study involving 1,113 patients who underwent ES for CBDS between 1977 and 1990 in Sweden.
• Matched population-based controls were assigned using the Swedish population registry.
• Data on morbidity and mortality were collected through linkage with the Inpatient Registry.

Main Results:

• A significantly higher overall morbidity was observed in patients who underwent ES compared to controls.
• A trend towards increased mortality was noted in the ES patient group.
• Recurrent CBDS occurred in 4.1% of patients. Acute cholangitis (HR 36) and acute pancreatitis (HR 6.2) were identified as probable long-term complications.

Conclusions:

• Acute pancreatitis and cholangitis are considered probable long-term complications following endoscopic sphincterotomy for common bile duct stones.
• ES patients exhibit increased long-term morbidity and a tendency towards higher mortality.
• The findings highlight the importance of monitoring for these specific complications post-ES.