Duodenoscopic sphincterotomy in a northern Indian hospital.

In a 36-month period, 154 duodenoscopic sphincterotomies (DS) were performed on 120 patients in a Northern Indian hospital. The major indication for DS was choledocholithiasis (95.8%), the rest being done for indications like papillary stenosis, periampullary carcinoma and the sump syndrome. Seven patients (5.8%) had significant associated medical illnesses. An adequate sphincterotomy was achieved in 91.6% of patients, with successful stone extraction in 95.3% of them. Overall clearance of the common bile duct (CBD) was thus achieved in 87.5% of the patients subjected to DS. Two patients (1.7%) died after undergoing DS, and six (5%) experienced early complications that necessitated emergency operation in two of them (1.7%). DS appears to be the treatment of choice for the management of choledocholithiasis in the postcholecystectomy patient as well as in the patient with gallbladder in situ who has cholangitis or jaundice or associated medical illness that may constitute a high risk for surgery.