[Endoscopic papillotomy in benign biliary tract diseases: nature, frequency and severity of complications]

The purpose of this study was to evaluate the frequency, nature and significance of the complications of endoscopic sphincterotomy. Between 1989 and 1993 endoscopic sphincterotomy was performed in 973 patients with benign affections of the bileducts. 398 patients were our own and 575 were admitted from other hospitals. The complications were recorded retrospectively on the basis of the discharge reports, which were available for each of our own patients (group A) and for 85% of the admitted patients (group B). Complications in all group A patients mentioned in the discharge reports were recorded and their clinical relevance was evaluated based on the patient records. Complications were mentioned in the reports of 82 (9.2%) of 887 cases and were more frequent in patients of group B (52 of 489: 10.6%) than in patients of group A (30 of 398: 7.6%). Pancreatitis was mentioned significantly more frequent in group B (2.5% vs 5.7%, p < 0.02). Reviewing the patient records of group A showed that clinically significant complications occurred in only 8 (2%) of 398 cases. The other complications mentioned in the discharge reports could not be confirmed or were without clinical significance. Hospitalization was short for these patients (5.3 +/- 2.2 days), which points to the fact that the findings were insignificant. 2 (0.2%) of 887 patients underwent surgery and 2 (0.2%) of 887 patients died due to a complication. These results clearly show that the complication rate determined on the basis of the discharge reports alone overestimates the true morbidity of the procedure. Often, an elevated amylase after ERCP/endoscopic sphincterotomy was erroneously interpreted as a pancreatitis.(ABSTRACT TRUNCATED AT 250 WORDS)