Long-term follow-up after endoscopic sphincterotomy (EST). 1988

E Seifert
1st Medical Department, Municipal Hospital Kemperhof, Koblenz, FRG.

Long-term results after endoscopic sphincterotomy (EST) revealed disappearance or improvement of symptoms in 92.0%. The symptoms remained unchanged in 6.2% and deteriorated in only 1.8%. X-ray follow-up studies showed concrement-free bile ducts in 85.2%, recurrent stones in 11.3%, and a stenosis of EST in 3.5%. Satisfactory long-term results depend on the indication for EST. The results of EST for choledocholithiasis are much better than for papillary stenosis (symptom-free or improved = 91.7%: 83.7%, unchanged = 6.4%: 14.3%, deteriorated = 1.9%: 2.0%). An EST-related stenosis was more than five times more frequent (16.8%: 2.9%) in papillary stenosis than choledocholithiasis. A gallbladder in situ does not seem to be an additional risk factor after EST. Subsequent cholecystectomy was performed in only 16.2% (routinely and elective), and in only 2.0% as an emergency procedure. In approximately 50% of the cases aerobilia and reflux, and in about 100% bacteriocholia, are observed after EST. When the free outflow of bile is ensured, it is not probable that late secondary diseases will develop.

UI MeSH Term Description Entries
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002761 Cholangitis Inflammation of the biliary ductal system (BILE DUCTS); intrahepatic, extrahepatic, or both. Cholangitides
D002763 Cholecystectomy Surgical removal of the GALLBLADDER. Cholecystectomies
D003137 Common Bile Duct Diseases Diseases of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001424 Bacterial Infections Infections by bacteria, general or unspecified. Bacterial Disease,Bacterial Infection,Infection, Bacterial,Infections, Bacterial,Bacterial Diseases
D013105 Sphincterotomy, Transduodenal Surgical incision of the SPHINCTER OF ODDI in the management of COMMON BILE DUCT DISEASES (e.g., CHOLEDOCHOLITHIASIS; and SPHINCTER OF ODDI DYSFUNCTION). Sphincteroplasty, Transduodenal,Sphincterotomy, Transhepatic,Sphincteroplasty, Transhepatic,Transduodenal Sphincteroplasties,Transduodenal Sphincteroplasty,Transduodenal Sphincterotomies,Transduodenal Sphincterotomy,Transhepatic Sphincteroplasties,Transhepatic Sphincteroplasty,Transhepatic Sphincterotomies,Transhepatic Sphincterotomy
D042882 Gallstones Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER, resulting in the condition of CHOLELITHIASIS. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, or bilirubin. Biliary Calculi,Common Bile Duct Gall Stone,Common Bile Duct Gallstone,Gallstone,Biliary Calculi, Common Bile Duct,Common Bile Duct Calculi,Common Bile Duct Gall Stones,Common Bile Duct Gallstones,Gall Stone,Gall Stones,Gall Stones, Common Bile Duct,Gallstones, Common Bile Duct,Calculi, Biliary
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