[Late results of transduodenal sphincterotomy and sphincteroplasty based on 18 years of experience (with special respect to the analysis of unsatisfactory results) (author's transl)].

In the course of 18 years the authors performed transduodenal sphincterotomy on 289 and sphincteroplasty on 87 patients. The operations were connected, in 295 cases with primary in 81 cases with repeated biliary surgery. Twenty of the patients (5.3%) died during the immediate postoperative period. However, on the grounds of autopsy data the death of only 10 patients (2.6%) can be attributed to the surgery of the sphincter. Out of the 356 surviving patients 270 were available for a follow-up study and were examined 1-11 years after the operation. Late results of the operation were found excellent or good in 89.6% of the patients. To clear up the unsatisfactory results clinical, laboratory, radiological, and endoscopic examinations were carried out. The unsatisfactory results can be explained by biliopancreatic (6.6%), organic extrabiliary (0.7%) and non-organic (1.5%) reasons. The authors emphasize the significance of endoscopic examinations following the surgery of the sphincter in the elucidation of the causes of unsatisfactory results.