endoscopic sphincterotomy long term consequences

October 30, 2007

My son has had quite a few endoscopic sphincterotomies with ERCPs for

stones obstructing his common bile duct (after his gallbladder was

removed). The last one the doctor made a 'huge' cut to establish bile

flow. So there is now a permanent opening that can cause lots of

problems and the former doctor was criticized for what he did but i

don't know if there was a better alternative ??

He has bile acid gastritis as a consequence because the bile can back

up into his stomach- he has poor motility in his gut because he has

short gut also. He has had pneumobelia (sp?) found on his ultrasounds

because air can back up into his biliary tract. He can even have food

particles back up into his biliary system. He is also at higher risk

for ascending cholangitis apparently with everything being so open (ie

no stop valve with spichter of oddi) for things refluxing into his

biliary tract. He also has no ileocecal valve so he has chronic small

bowel bacterial overgrowth problems so a complex set of issues to work

with.

One of my biggest concerns is that he would never be able to receive a

living donor transplant- at least I don't think he could because of

this. I know the wait time can be very long so I would have liked for

him to at least had living donor as an option- any thoughts on this ?

Has anyone else had this done because of so many common bile duct

obstructions/ERCPs ? We were told when all the problems started that

ideally he would have had a roux en y to establish bile drainage, but

because he has no 'spare' small bowel that wasn't possible.

Lori

lucky mom blessed with triplets

November 1, 2007

any thoughts ?

>

> My son has had quite a few endoscopic sphincterotomies with ERCPs for

> stones obstructing his common bile duct (after his gallbladder was

> removed). The last one the doctor made a 'huge' cut to establish bile

> flow. So there is now a permanent opening that can cause lots of

> problems and the former doctor was criticized for what he did but i

> don't know if there was a better alternative ??

> He has bile acid gastritis as a consequence because the bile can back

> up into his stomach- he has poor motility in his gut because he has

> short gut also. He has had pneumobelia (sp?) found on his ultrasounds

> because air can back up into his biliary tract. He can even have food

> particles back up into his biliary system. He is also at higher risk

> for ascending cholangitis apparently with everything being so open (ie

> no stop valve with spichter of oddi) for things refluxing into his

> biliary tract. He also has no ileocecal valve so he has chronic small

> bowel bacterial overgrowth problems so a complex set of issues to work

> with.

>

> One of my biggest concerns is that he would never be able to receive a

> living donor transplant- at least I don't think he could because of

> this. I know the wait time can be very long so I would have liked for

> him to at least had living donor as an option- any thoughts on this ?

> Has anyone else had this done because of so many common bile duct

> obstructions/ERCPs ? We were told when all the problems started that

> ideally he would have had a roux en y to establish bile drainage, but

> because he has no 'spare' small bowel that wasn't possible.

>

> Lori

> lucky mom blessed with triplets

>

November 1, 2007

I've had one sphincterotomy when I was first diagnosed, had

pancreatitis from it and since then haven't had another (9 years or

so). I don't know much, but some people can have partial transplants

(not sure if this applies to us, but i'll mention it). You sound

understandably stressed, but I've gotta let you know my parents

thought that they were gonna lose me when i was 18 and then things got

progressively better out of nowhere.

Good luck