Endoscopic management of bile duct stones at Auckland Hospital in 1988 and 1989.

Objects: to define the role of endoscopic management of bile duct calculi in a tertiary referral institution.

Methods: an unselected series of 466 patients presenting for ERCP over a two year period were reviewed and 103 patients with bile duct calculi identified. The results of endoscopic management of these patients is reviewed.

Results: endoscopic sphincterotomy was successful in 98% of patients, and resulted in clearance of calculi from the bile duct in 75%, and in a further 8% symptoms were successfully controlled by sphincterotomy with or without endoprostheses, despite residual calculi. Seventy-nine percent of the patients with choledocholithiasis were successfully managed endoscopically, minor complications occurring in 16% which were significant in only 4%, with no procedure related mortality.

Conclusions: endoscopic sphincterotomy provides a safe and effective means of managing bile duct calculi, even if stone extraction cannot be completed.