Background and Study Aims: There have been growing concerns about the long-term sequelae of endoscopic sphincterotomy (ES). The aims of the study were to evaluate the long-term clinical outcome of ES for choledocholithiasis and to identify the predictors of recurrence. Patients and Methods: A total of 529 patients (233 men, 296 women; mean age 63, range 9–88) who underwent successful ES for choledocholithiasis were evaluated. Follow-up data were obtained retrospectively. Statistical analyses were carried out for 334 patients who had a follow-up of at least 5 years or had recurrence. Results: Immediate complications occurred in 37 patients (7 %). Follow-up data were available in 458 patients (86.6 %), of whom 280 (61.1%) were asymptomatic,127 (27.7%) died from unrelated causes without recurrence, and 51 (11.1%) had biliary symptoms and/or choledocholithiasis recurrence. Most recurrences (65%) occurred more than 2y ears following ES and were observed on multiple occasions in 13 patients (2.8 %). A bile duct diameter of 22mm or greater was found to predict recurrence. Of 190 patients with an intact gallbladder, 11 (5.8 %) developed acute cholecystitis necessitating emergency cholecystectomy; all of these had previously documented gallstones. Conclusions: Endoscopic sphincterotomy for choledocholithiasis is found to be safe at long-term follow-up. A dilated bile duct (‡ 22 mm) is a marker for patients at increased risk of recurrence of symptoms and/or choledocholithiasis.

Costamagna, G., Tringali, A., Shah, S., Mutignani, M., Zuccala', G., Perri, V., Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence, <<ENDOSCOPY>>, 2002; 34 (4): 273-279. [doi:10.1055/s-2002-23632] [http://hdl.handle.net/10807/113639]

Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence

Costamagna, Guido;Tringali, Andrea;Mutignani, Massimiliano;Zuccala', Giuseppe;Perri, Vincenzo
2002

Abstract

Background and Study Aims: There have been growing concerns about the long-term sequelae of endoscopic sphincterotomy (ES). The aims of the study were to evaluate the long-term clinical outcome of ES for choledocholithiasis and to identify the predictors of recurrence. Patients and Methods: A total of 529 patients (233 men, 296 women; mean age 63, range 9–88) who underwent successful ES for choledocholithiasis were evaluated. Follow-up data were obtained retrospectively. Statistical analyses were carried out for 334 patients who had a follow-up of at least 5 years or had recurrence. Results: Immediate complications occurred in 37 patients (7 %). Follow-up data were available in 458 patients (86.6 %), of whom 280 (61.1%) were asymptomatic,127 (27.7%) died from unrelated causes without recurrence, and 51 (11.1%) had biliary symptoms and/or choledocholithiasis recurrence. Most recurrences (65%) occurred more than 2y ears following ES and were observed on multiple occasions in 13 patients (2.8 %). A bile duct diameter of 22mm or greater was found to predict recurrence. Of 190 patients with an intact gallbladder, 11 (5.8 %) developed acute cholecystitis necessitating emergency cholecystectomy; all of these had previously documented gallstones. Conclusions: Endoscopic sphincterotomy for choledocholithiasis is found to be safe at long-term follow-up. A dilated bile duct (‡ 22 mm) is a marker for patients at increased risk of recurrence of symptoms and/or choledocholithiasis.
2002
Inglese
Costamagna, G., Tringali, A., Shah, S., Mutignani, M., Zuccala', G., Perri, V., Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence, <<ENDOSCOPY>>, 2002; 34 (4): 273-279. [doi:10.1055/s-2002-23632] [http://hdl.handle.net/10807/113639]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/113639
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