Endoclip Papillaplasty Restores Sphincter Of Oddi Function: Pilot Study

Objectives: Endoscopic sphincterotomy (EST) damaged the sphincter of Oddi (SO) function. This study aimed to explore the feasibility and efficacy of endoclip papillaplasty in restoring SO function.Methods: This prospective pilot study included consecutive patients with choledocholithiasis (stone size >= 10 mm) who underwent large-EST for stone removal, followed by endoclip papillaplasty, between May 2018 and March 2019.Results: Thirty patients were enrolled in this trail. Overall, 80% of the patients had a SO basal pressure of >10 mmHg after endoclip papillaplasty. Manometric parameters, including SO basal pressure, phasic wave contraction amplitude, phasic waves per minute, recovered after endoclip papillaplasty (P > 0.05). There were no significant differences in the manometric parameters of SO between healing grades A and B. Six patients developed mild post-endoscopic retrograde cholangiopancreatography pancreatitis, including three that had pancreatic stenting. Bile duct stone recurrence developed in 3.3% of the patients (1/30) during an 18-month follow-up.Conclusions: Endoclip papillaplasty might restore SO function and possibly prevented biliary stone and cholangitis recurrence.