XXXX : endoscopic treatment and late recurrence.

@entity254 @entity1 @entity9834
OBJECTIVE: @entity9834 is a rare complication of biliary-enteric @entity254 . Classically, the distal bile duct becomes obstructed by food, stones, or debris after choledochoenterostomy. Endoscopic sphincterotomy has been recommended as the primary and definitive treatment modality. The aim of our study was to confirm the short and long term therapeutic efficacy of endoscopic treatment in a long follow-up period. METHODS: The series include 31 @entity1 with characteristic clinical illness after choledochoduodenostomy. All of them were successfully treated by endoscopic sphincterotomy and bile duct clearance with a balloon catheter or basket. The follow-up period ranged from 18 to 84 months (median: 51 months). RESULTS: Clinical improvement was immediate in all @entity1 . No complications were recorded. Recurrence of the syndrome, with restenosis of the sphincterotomy opening, was observed in six @entity1 (19%) and was treated successfully and safely with a new papillotomy. @entity9834 recurrence occurred 31-72 months (median: 58.5 months) after the initial treatment. CONCLUSIONS: We report a considerably high recurrence rate of @entity9834 after initially successful endoscopic management and its effective endoscopic treatment with a new papillotomy. We still believe that the primary therapeutic approach in @entity1 with @entity9834 should be endoscopic.
