Endoscopic sphincterotomy for bile duct stones

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Biliary Tract Interventions

Background:

• Bile duct stones (choledocholithiasis) pose significant clinical challenges.
• Endoscopic sphincterotomy (ES) is a primary treatment modality for bile duct stones.
• Assessing the efficacy and safety of ES in a diverse patient cohort is crucial.

Purpose of the Study:

• To evaluate the outcomes of endoscopic sphincterotomy for bile duct stones.
• To describe a novel sphincterotomy handle and diathermy wire design.
• To identify factors influencing success rates and complications.

Main Methods:

• Retrospective analysis of 50 patients undergoing endoscopic sphincterotomy for bile duct stones.
• Utilized a newly designed sphincterotomy handle and diathermy wire.
• Assessed success rates, stone clearance, complication frequency, and long-term recurrence.

Main Results:

• Successful sphincterotomy achieved in 90% (45/50) and complete stone clearance in 84% (42/50) of patients, often requiring two procedures.
• Complications occurred in 9% (9/50), including hemorrhage (1 laparotomy) and pancreatitis (1 death).
• Periampullary diverticula and stone size did not significantly impact outcomes, though multiple stones (>10) reduced clearance rates.

Conclusions:

• Endoscopic sphincterotomy is a highly effective and valuable treatment for bile duct stones in both high-risk and low-risk patients.
• The described sphincterotomy device facilitates successful stone removal.
• Long-term symptom recurrence was not observed up to three years post-procedure.