Does endoscopic sphincterotomy cause prolonged pancreatobiliary reflux?

The American Journal of Gastroenterology
M Sugiyama, Y Atomi

Abstract

Endoscopic sphincterotomy (ES) reduces sphincter function, which may allow reflux of pancreatic juice and intestinal contents into the common bile duct. The reflux, if present, may cause development of biliary tract carcinomas, as may anomalous pancreaticobiliary junction. We prospectively investigated pancreatobiliary and duodenobiliary reflux after ES. In 15 patients with choledocholithiasis, ductal bile was sampled for amylase concentration and bacterial culture during endoscopic retrograde cholangiopancreatography, before and at 7 days to 5 yr after ES. To provide comparative data, ductal bile was sampled in 11 patients with gallbladder cholesterol polyps or anomalous pancreaticobiliary junction who did not undergo ES. Amylase concentration of ductal bile in patients with choledocholithiasis before ES was not different from that in patients with gallbladder polyps. Its concentration was increased 7 days after ES compared with that before ES, reaching the level of that in patients with anomalous pancreaticobiliary junction. Thereafter, amylase concentration gradually decreased, returning to that before ES by 1 yr. After ES, bactobilia occurred in 60-80% of patients, although none developed acute cholangitis. Although ES caus...Continue Reading

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Citations

Nov 27, 2008·World Journal of Gastroenterology : WJG·Terumi KamisawaKouji Tsuruta
Mar 1, 2012·World Journal of Gastroenterology : WJG·John KalaitzisAndreas Polydorou
Sep 28, 2016·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Jie-Gao ZhuZhong-Tao Zhang
Jul 28, 2004·Gastrointestinal Endoscopy·Masanori Sugiyama, Yutaka Atomi
Aug 28, 2001·Scandinavian Journal of Gastroenterology·M Sugiyama, Y Atomi
Oct 3, 2007·Journal of Hepato-biliary-pancreatic Surgery·Mitsuhiro InagakiShinichi Kasai
Apr 16, 2010·Journal of Hepato-biliary-pancreatic Sciences·Terumi KamisawaUNKNOWN Committee of Diagnostic Criteria of The Japanese Study Group on Pancreaticobiliary
Oct 7, 2010·Journal of Hepato-biliary-pancreatic Sciences·Noritoshi KobayashiItaru Endo
Jun 6, 2013·Journal of Gastroenterology·Jun HoraguchiUNKNOWN committee of Diagnostic Criteria of The Japanese Study Group on Pancreaticobiliary Maljunction
Nov 14, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Matias E CzerwonkoMartín Palavecino

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