[Delayed stenosis after endoscopic sphincterotomy (EST)?]

To answer the question of restenosis following endoscopic sphincterotomy (EST) different and sophisticated methods were performed. Using the Erlangen type papillotome we developed a practicable and standardised method for measurement of the size of the EST that is able to define a restenosis. Depending on the indication for EST we found different percentages of restenosis: common bile-duct stones 14%, papillary stenosis 23.1%, duodenal diverticula without bile duct stones as cholestatic entity 40%. On one hand reduction of EST size is not corresponding to clinical symptoms, on the other hand the symptoms of patients after EST with sufficient EST size have to explained in other ways such as gall bladder still existing. Due to these experiences in patients with symptoms following EST we propose a control ERC combined with mechanical measurement of the sphincterotomy size.