XXXX : results of treatment by endoscopic sphincterotomy.

@entity1 @entity1377 @entity1690 @entity10747
From a consecutive series of 451 @entity1 with post-cholecystectomy symptoms referred for @entity10747 ( @entity10747 ), 40 (9 per cent) were diagnosed as having @entity1690 . Eight @entity1 were excluded from the study because of incomplete data (n = 6) or additional diagnoses (n = 2). Thirty of the @entity1 had successful @entity10747 and endoscopic sphincterotomy (ES); this failed in the remaining two because of severe @entity1377 (6.3 per cent). Endoscopic biliary manometry was performed in 23 @entity1 (77 per cent). Immediate post-ES complications occurred in eight @entity1 (25 per cent). At a median follow-up of 46 months (range 10-88 months) 19 @entity1 had a good outcome (63.3 per cent) and 11 @entity1 had a poor outcome (36.7 per cent). @entity1 with a good outcome tended to have a delay of months or years following cholecystectomy before the development of symptoms (median 6 years versus 0 years, P = 0.0003). At @entity10747 , @entity1 with a good outcome had greater common bile duct diameters (mean +/- s.d. mm, 12.6 +/- 3.6 versus 8.8 +/- 1.8, P = 0.0003) and delayed drainage from the biliary tree of injected contrast (13 versus 2 @entity1 , P = 0.02). Endoscopic biliary manometry was abnormal in all 15 @entity1 with a good outcome in whom it was performed but in only 3 out of 8 @entity1 with a poor outcome (P = 0.003). @entity1690 is an important, albeit uncommon, cause of post-cholecystectomy symptoms. ES provides symptomatic relief in the majority of @entity1 but improved criteria for predicting outcome are required.
