Is Endoscopic Sphincterotomy Sufficient in the Treatment of Sump Syndrome? A 25-Year Experience

Sump syndrome is one of the rare long-term complications of side-to-side choledochoduodenostomy (CD) leading to attacks of cholangitis due to accumulation of food and debris in the common bile duct distal to the anastomosis is one of the rare long-term complications after CD. Fifteen patients treate...

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Published inJournal of laparoendoscopic & advanced surgical techniques. Part A Vol. 34; no. 5; p. 430
Main Authors Şal, Oğuzhan, Serin, Kürşat Rahmi, Ercan, Leman Damla, Göksoy, Beslen, Al Hajeh, Anas, Ekiz, Feza, Tekant, Yaman
Format Journal Article
LanguageEnglish
Published United States 01.05.2024
Subjects
Adult
Aged
Cholangiopancreatography, Endoscopic Retrograde - methods
Choledochostomy - methods
Female
Humans
Male
Middle Aged
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Recurrence
Reoperation - statistics & numerical data
Retrospective Studies
Sphincterotomy, Endoscopic - methods
Treatment Outcome
choledocholithiasis
ERCP
hepaticojejunostomy
Sump syndrome
choledochoduodenostomy
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Summary:Sump syndrome is one of the rare long-term complications of side-to-side choledochoduodenostomy (CD) leading to attacks of cholangitis due to accumulation of food and debris in the common bile duct distal to the anastomosis is one of the rare long-term complications after CD. Fifteen patients treated with the Sump syndrome in our institution between 1996 and 2023 were retrospectively evaluated for long-term outcome. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and bile duct clearance was done in 11 patients, while four were subjected to revisional surgery in the form of a Roux-en-Y hepaticojejunostomy. No complications were recorded. There were 5 (38%) recurrences in a median follow-up period of 8 years (10 months-23 years). Of those, 3 patients were treated surgically and two with repeat ERCP. None of the patients developed any cholangiocarcinoma during follow-up. We conclude that although a high recurrence rate was observed, endoscopic treatment may be a valid approach in the treatment of Sump syndrome, with revisional surgery in the form of a Roux-en-Y hepaticojejunostomy as salvage therapy in recurrences.
ISSN:1557-9034
DOI:10.1089/lap.2023.0519