Five years experience of endoscopic sphincterotomy in Japan: a collective study from 25 centres

Five years experience of Endoscopic Sphincterotomy (EST) in Japan has been analyzed in 468 collective cases from 25 centres. In the indication of EST, biliary tract stones were the main reason, and shared in 92.5% of the success of EST. Other applications were benign stenosis of the papilla of Vater, ascaris of the common bile duct and so on where these formed a small group in the indication of EST. Complete removal of stones had been observed spontaneously in 62.3% of the cases, and with the help of a basket or balloon catheter in 23.7% of successful EST. However, fourteen percent of EST had no effect on the delivery of gallstones. Complications during and after EST were observed in 8.5% of all cases where hemorrhage, pancreatitis and cholangitis were the main hazards. The mortality rate was 0.4%, a considerably low rate when the figure is simply compared with that of cases involving surgical intervention. Finally, the term of Endoscopic Sphincterotomy (EST) was proposed for this procedure because it proved to be the best expression of the actual procedure.