Gall bladder function after endoscopic sphincterotomy.

Endoscopic sphincterotomy with extraction of the stones is often the only treatment for stones in the bile duct in patients considered unfit for surgery. Most of these patients fare well even when they have stones in the gall bladder; cholecystectomy for biliary colic, acute cholecystitis, or jaundice was necessary in less than 15% followed up for up to seven years. 2 After the procedure patients retain their gall bladder and have an incompetent lower bile duct sphincter; little is known about the subsequent function of the gall bladder, although changes in the metabolism of bile acids have been reported.3 In a patient who had recently had an endoscopic sphincterotomy to remove stones we noted the absence of filling of the gall bladder during biliary excretion scintigraphy, although the cystic duct had been patent at endoscopic cholangiography. We therefore undertook a prospective study of gall bladder function after endoscopic sphincterotomy for ductal stones.