Table of Contents
Diagnostic and Therapeutic Endoscopy
Volume 2014, Article ID 745790, 5 pages
http://dx.doi.org/10.1155/2014/745790
Research Article

Late Complications following Endoscopic Sphincterotomy for Choledocholithiasis: A Swedish Population-Based Study

1Department of Surgery, University Hospital, 75185 Uppsala, Sweden
2Department of Medical Epidemiology and Biostatistics, Karolinska Institute, 171 77 Stockholm, Sweden

Received 20 May 2014; Revised 2 September 2014; Accepted 24 September 2014; Published 16 October 2014

Academic Editor: Tony C. K. Tham

Copyright © 2014 A. Langerth et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In order to assess the risk of long-term complications following endoscopic sphincterotomy (ES) for common bile duct stones (CBDS), we conducted a cohort study. The study included 1,113 patients who underwent ES for CBDS in six different hospitals in central Sweden between 1977 and 1990. Through the use of the Swedish population registry, each patient was assigned five population-based controls matched for sex and age. Linkage to the Inpatient Registry yielded information on morbidity and mortality for the patients as well as for the controls. After one year of washout, there were 964 patients available for follow-up. The mean age was 70.6 years, 57% were women, and the mean length of follow-up was 8.9 years. The patients’ overall morbidity was significantly higher and we observed a tendency towards increased mortality as well. Recurrent CBDS was diagnosed in 4.1% of the patients. Acute cholangitis with a hazard ratio (HR) of 36 (95%CI 11–119.4) was associated with recurrent CBDS in 39% of the patients. HR for acute pancreatitis was 6.2 (95%CI 3.4–11.3) and only one patient had CBDS at the same time. In conclusion, we consider acute pancreatitis and cholangitis both as probable long-term complications after ES.