Endoscopic sphincterotomy for the treatment of biliary sump syndrome

Biliary "sump" syndrome is a rare but embarrassing problem after side-to-side choledochojejunostomy or choledochoduodenostomy. Four patients with they syndrome treated nonoperatively by endoscopic sphincterotomy are described. Three of these had had choledochojejunostomy previously and the other inadvertent choledochoduodenostomy at prior common duct exploration. Cholangitic symptoms or biliary obstruction disappeared and the patients have been well for periods ranging from 2 to 5.5 years. Endoscopic sphincterotomy can eliminate the stasis area of the common duct distal to the lateral anastomosis, obviating relaparotomy, and may deserve first consideration in patients with the sump syndrome.