The role of endoscopic sphincterotomy as a therapy of patients with post cholecystectomy syndrome

Gallstones are among common coplaints of human societies. Its prevalence has been estimated about 10% in western societies. As operational manipulation is still the method of choice in syptomatic gallstones,post operative side effects and coplaints,like retained stone in common bile duct,are studied. In a retrospective study we have reviewed the files of the patients hospitalized in Khatam_ol_Anbia Hospital due to post-operative side-effects of cholecystectomy in 1999. We have studied 34 patients with post cholecystectomy syndrome. The mean age was 61 year. RUQ pain was the most common complaint of the patients and high level of alkaline phosphatase was the most common laboratory finding. Retained gallstones were diagnosed much more than bile duct stenosis and stump syndrom. Among 26 patients with remained gallstones, sonography has successfully diagnosed 21 cases,wherase ERCP has determined definite diagnosis. Endoscopic sphinetrotomy was successfully performed in 18 patients,but the remainers (16 patients) required surgical intervention. Remaining gallstone is the most common copliant of post-cholecystectomy syndrome that demands careful attention during gall bladder surgery,especially in old patients. In. case of encountering this problem,endoscopic sphietrotomy should be the first choice,then in case of failure, reoperation is recommended.