Endoscopic treatment of biliary-tract diseases. An international study.

Data on endoscopic sphincterotomy from 15 gastroenterology centres with very wide experience show that 3618 out of 3853 (93.%) attempts at the procedure were successful. The main indication for sphincterotomy was choledocholithiasis (3070, or 84.9% cases). After sphincterotomy the stones passed spontaneously or were removed in 2779 (90.5%) cases. Bleeding, cholangitis, pancreatitis, perforation, and stone impaction occurred in 254 (7.0%) cases; the mortality-rate was 1.4%. 83 (2.3%) cases required emergency surgery. Endoscopic sphincterotomy is increasingly replacing surgery in the treatment of choledocholithiasis.