<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p><italic>Background:</italic> Role of endoscopic sphincterotomy (ES) in high risk patients with choledocholithiasis is established but its role in good risk patients is unclear.</p> <p><italic> Design:</italic> A prospective randomized trial of endoscopic sphincterotomy followed by surgery (ES + S) versus surgery alone (SA) in good risk patients with choledocholithiasis.</p> <p><italic>Setting:</italic> A tertiary level referral hospital in north India; July 1991 to October 1993.</p> <p><italic>Patients and methods</italic>: Thirty three out of 60 patients with choledocholithiasis were found suitable for
randomization-16 were randomised to ES+S group and 17 to SA group.</p> <p><italic>Results:</italic> Common bile duct clearance was achieved in 11/13 (85%) patients in ES+S group and in 13/15 (87%) in SA group. Major complications occurred in 4/13 (31%) patients in ES+S group and 3/16 (19%) patients in SA group. These differences were not statistically significant, but patients in ES+S group were exposed to morbidity twice, procedure related morbidity of ES being 23%. No significant differences were observed in hospital stay and cost of treatment.</p> <p><italic>Conclusions:</italic>  Results of this trial do not support use of precholecystectomy ES in good risk patients with choledocholithiasis, since it did not offer any advantage over surgery alone.</p>
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HPB Surg. 1996; 9(3):145-148