Endoscopic sphincterotomy has become the first line treatment for patients with common bile duct (CBD) stones. This technique may fail, however, due to difficult anatomy, previous surgery, periampullary diverticula or the presence of a large stone. The importance of stone size to the success of endoscopic sphincterotomy has not been fully assessed. A prospective study was carried out over the p...

We report a case of mediastinal and bilateral retro-orbital emphysema following an uncomplicated endoscopic sphincterotomy. The concurrent presence of these complications following endoscopic retrograde cholangiopancreatography is rare. The simultaneous occurrence of these two complications in the same patient has not been previously reported in the literature. Furthermore, we define the first ...

AIM precut sphincterotomy refers to a variety of endoscopic techniques that are used in order to access the bile duct when conventional methods of cannulation have failed. There are not significant data (such as efficacy, safety) about the use of different techniques of precutting at the same session. We have described our experience with combined precut sphincterotomy (CPS) and we have compare...

Objectives: The objective of this study is: To determine frequency of persistent postoperative incontinence in closed lateral internal sphincterotomy for chronic anal fissure. Study design: Descriptive study (Case series). Place and duration: The study was undertaken at the department of the General Surgery, Nishtar Hospital Multan from Nov5,2008 to May 5, 2009. Material and methods: One hundre...

Aim: To investigate the rectal and anal sphincter factors that might contribute to the development of fecal incontinence (FI) after anal fissure and rectal prolapse surgery. Methods: Fourteen patients with FI after sphincterotomy (n = 8) and rectal prolapse surgery (n = 6) were studied [clinical assessment, rectosigmoidoscopy, anorectal manometry, including rectoanal inhibitory reflex (RAIR) me...

Background—Endoscopicretrogradecholangiopancreatography sphincterotomy is increasingly performed in younger patients undergoing laparoscopic cholecystectomy. However, the safety of endoscopic sphincterotomy in this age group, relative to that in older patients, is unknown. Aim—To determine whether the development of short term complications following endoscopic sphincterotomy is age related. Pa...

A consensus development approach was used to assess the extent to which doctors in the UK agreed about the appropriate indications for cholecystectomy. Two panels, one composed entirely of surgeons and one containing a mix of relevant specialists, were asked to rate a series of possible indications. A consensus was achieved for 61% (surgical panel) and 67% (mixed panel) of indications considere...