Endoscopic Sphingterotomy as A Therapy of Patients with Postoperative Complication of Cholecystectomy(Retrospective Study of 34 Patients in a Year)

Gallstones are among common complaints of human societies. Its prevalence has been estimated about 10% in western societies. As operational manipulation is still the method of choice in symptomatic gallstones, post-operative side effects and complaints, like remained gallstone in common bile duct, are studied. In a retrospective study we have reviewed the files of the patients hospitalized in Shariati Hospital due to post-operative side-effects of cholecystectomy, 1997. We have studied 34 patients with post-cholecystectomy syndrome. The mean age was 61. RUQ pain was the most common complaint of the patients, and high level of alkaline phosphatase was the most common laboratory finding. Remained gallstones were diagnosed much more than bile duct stenosis and stump syndrome. Among 26 patients with remianed gallstones, sonography has successfully diagnosed 21 cases, wliereas ERCP has determined definite diagnosis. Endoscopic sphincterotomny was successfully performed in 18 patinets, but the remaniers(16 patients) required surgical intervention Remaining gallstone is the most common complaint of post-cholecystectomy syndrome that demands careful attention during gall bladder surgery, especially in old patients. In case of encountering this problem, endoscopic sphincterotomy should be the first choice, fortunately it succeeds in more than half of the patients, then in case of unsuccess, reoperation is recommended.