[Endoscopic sphincterotomy]

The last 105 endoscopic sphincterotomies performed between 1983 and 1987 are evaluated and compared with the recent data of the literature. The sphincterotomy has been successful in 98 cases (93%). The indications were: 95 cases of common bile duct stones and 10 inflammatory stenoses of the duodenal papilla. The stones have been removed in all cases of sphincterotomy for choledocholithiasis (100% of the successful sphincterotomies, 93% of all attempts). The morbidity rate was 5%. There has been no need for emergency intervention. Mortality was zero. In order to obtain high success rates with endoscopic sphincterotomies and removal of stones with minimal morbidity and mortality, the procedure should be performed by an experienced operator who avoids precutting in case of difficult insertion and who makes calibrated incisions related to the volume of the stones (not larger than 2 cm). Endoscopic sphincterotomy is a safe method of treatment for choledocholithiasis and papillary stenosis. It carries a lower morbidity and mortality than surgery.