Endoscopic retrograde sphincterotomy in the management of common bile duct stones

Endoscopic retrograde sphincterotomy (ERS) was performed in 53 patients with choledocholithiasis, 26 of whom had an intact gallbladder. An adequate sphincterotomy was achieved in every patient, and all stones were removed in 90%. There was 9% morbidity but no mortality. ERS is a major advance in the management of common bile duct stones with significantly lower morbidity and mortality than those associated with conventional surgery. In particular, the role of ERS in pre-cholecystectomy patients is discussed.