From January 1988 to December 1994, endoscopic sphincterotomy with stone extraction was attempted in 395 patients with common duct stones at Yeungnam University Hospital. Endoscopic sphincterotomy was successful in 3989 patients(98.5%), and
clearance of
the duct was achieved in 364 patients with an overall success rare of 92.2%. After sphincterotomy, stone extraction by basket or balloon was undertaken in 298 patients without lithotripsy, and stones could be extracted after fragmentation of
stones
in
19 patients. In 47 patients, stones were passed into duodenum spontaneously. There were 6 cases of sphincterotomy failure due to large periampullary diverticulum or previous gastrojejunostomy. In patients with successful sphincterotomy,
endoscopic
stone
extraction was failed in 25 cases due to 14 large stones, 5 bile duct strictures, 4 impacted stones, and 2 cases of technical failure. Complication were developed in 13 patients(3.3%); 8 pancreatitis and 5 bleedings. All of them were improved
with
medical therapy only. Despite relatively high success rate and low complications of the endoscopic management of choledocholithiasis, there were significant difficulties in removing large stones. Development of more effective and inexpensive
methods of
lithotripsy, and the search for rapidly effective solvent dissolving stones needed. (Kor J Gastrointest Endosc 15: 697~701, 1995)
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