Clinical, biochemical and ultrasonographic findings of choledochal sphincteroplasty. A 1 to 14 year follow-up study.

Sixty patients, who underwent choledochal sphincteroplasty and then yearly referred to the department for a diagnostic check-up, entered this study. Follow-up ranged from 1 to 14 years after surgery. Check-up examination included: 1) clinical assessment, 2) serum liver and pancreas function tests, and 3) ultrasonography. Good long-term clinical results were obtained in 50 cases. Seven patients complained of mild and temporary hepatic symptoms or digestive troubles. Three subjects developed severe symptoms: jaundice, fever, pain or ascites. The causes of the failures were: 1) recurrent stones in the distal portion of the common bile duct with cholangitis, 2) common hepatic duct stricture with recurrent stones and cholangitis, and 3) alcoholic cirrhosis. The following conclusions may be drawn: 1) Sphincteroplasty achieved a fourteen year success rate of 90% 2) Cholangitis, which supervened in 2 patients, was associated with bile duct strictures and recurrent stones. 3) The great majority of patients who had undergone sphincteroplasty, showed normal size of the bile ducts. However, 10% of patients still retained some degree of intrahepatic ductal dilatation. 4) Since recurrent bile duct stenoses occurred as far as 6 and 8 years after surgery, long-term follow-up is mandatory.