Background: Endoscopic sphincterotomy (ES) carries a substantial risk of recurrent choledocholithiasis but retreatment with endoscopic retrograde cholangiopancreatography (ERCP) is safe and feasible. However, long term results of repeat ERCP and risk factors for late complications are largely unknown. Aims: To investigate the long term outcome of repeat ERCP for recurrent bile duct stones after ES and to identify risk factors predicting late choledochal complications. Methods: Eighty four patients underwent repeat ERCP, combined with ES in 69, for post-ES recurrent choledocholithiasis. Long term outcomes of repeat ERCP were retrospectively investigated and factors predicting late complications were assessed by multivariate analysis. Results: Complete stone clearance was achieved in all patients. Forty nine patients had no visible evidence of prior sphincterotomy. Two patients experienced early complications. During a follow up period of 2.2-26.0 years (median 10.9 years), 31 patients (37%) developed late complications, including stone recurrence (n = 26), acute acalculous cholangitis(n = 4), and acute cholecystitis (n = 1). There were neither biliary malignancies nor deaths attributable to biliary disease. Multivariate analysis identified three independent risk factors for choledochal complications: interval between initial ES and repeat ERCP

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Using a commercially available flat crystal spectrometer in a slightly modified form, an investigation was made of the peak intensity ratios (Kβ5/Kβ1) and the relative intensities of Kβ″ to Kβ5 in different oxidation states of 3d‐transition metal atoms existing in forms of oxidic compounds. The peak intensity ratios (Kβ5/Kβ1) for V, Cr, Mn, Fe, Co, Ni and Cu, as well as the peak profiles of Kβ″ and Kβ5 for V, Cr and Mn, were investigated. Results suggest that changes in the intensities of the Kβ5 and Kβ″ bands can be applied to determining the oxidation number of a metal atom in its oxide.