Endoscopy 2003; 35(4): 356-359
DOI: 10.1055/s-2003-38137
Case Report
© Georg Thieme Verlag Stuttgart · New York

Recurrent Pancreatitis as a Late Complication of Endoscopic Sphincterotomy for Common Bile Duct Stones: Diagnosis and Therapy

P.  Rolny 1 , A.  Andrén-Sandberg 2 , A.  Falk 3
  • 1 Department of Medicine, Division of Gastroenterology, Hepatology and Surgery, Sahlgrenska University Hospital-Östra, Gothenburg, Sweden
  • 2 Queen Sylvia Children’s Hospital, Gothenburg, Sweden
  • 3 University of Gothenburg, Gothenburg, Sweden
Further Information

Publication History

Submitted 16 March 2002

Accepted after Revision 26 July 2002

Publication Date:
27 March 2003 (online)

Although long-term complications of endoscopic sphincterotomy (ES) have often been reported, the possible effects of the procedure on the pancreatic duct orifice remain virtually unknown. Three women patients are described who developed attacks of recurrent pancreatitis at 2, 7, and 27 months after ES for bile duct stones. The attacks were apparently caused by a partial stenosis of the pancreatic orifice, arising from post-procedure fibrosis and scarring. The patients were evaluated and treated endoscopically. All three patients benefited from endoscopic therapy; two became symptom-free and one improved. Symptoms recurred in the three patients, after 26, 41, and 23 months. In one patient, re-stenosis was documented and repeat sphincterotomy resulted in complete relief of symptoms during the ensuing 5 months. In the remaining two patients, the symptoms were mild and no further intervention was needed. Concerning complications, one patient suffered a moderately severe pancreatitis without sequelae. Recurrent pancreatitis may emerge as a late complication after ES for common bile duct stones. It is probably causally related to stenosis of the pancreatic orifice brought about by fibrosis and scarring, which may exceptionally develop after the procedure. Endoscopic therapy should probably be considered in the first instance, but the optimal treatment for this condition remains to be determined.

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P. Rolny, M.D., Ph.D.

Department of Medicine, Division of Gastroenterology and Hepatology, Sahlgrenska University Hospital-Östra

Gothenborg · Sweden

Fax: + 46-31-259254 ·

Email: peter.rolny@vgregion.se

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