Fiberendoscopic cannulation of the papilla of Vater I. Sphincterotomy in the treatment of retained bile duct stones and benign papillary stenosis

Endoscopic sphincterotomy (EST) has been used as a treatment of 33 patients with bile duct stones and 3 patients with benign papillary stenosis. In 83% the papilla was cannulated and an adequate, 15 mm long, sphincterotomy was performed. In 72% the retained bile duct stones were extracted. All 3 patients with papillary stenosis had a free bile flow to the duodenum after the procedure and no complications were seen. Complications occurred in 4 patients (11%) with bile duct stones. The complications consisted of pancreatitis in 2 patients, bleeding in one patient and cholangitis in one patient. One of these patients died 5 days after the procedure because of extraperitoneal perforation of the duodenum accompanied by haemorrhagic pancreatitis. Although many of the patients were old and in poor condition endoscopic sphincterotomy was well tolerated when the procedure was uneventful. The method was usually painless and general anaesthesia was not required. The hospital stay after EST was 6.6 +/- 1 days on average.