A comparison of endoscopic papillary balloon dilation and endoscopic sphincterotomy for the removal of common bile duct stones
10.3760/cma.j.issn.0578-1426.2011.02.008
- VernacularTitle:内镜下乳头球囊扩张术和乳头括约肌切开术治疗胆总管结石的比较
- Author:
Tao YU
;
Liang LIU
;
Jian CHEN
;
Yanqing LI
- Publication Type:Journal Article
- Keywords:
Choledocholithiasis;
Sphincterotomy,endoscopic;
Endoscopic papillary balloon dilation
- From:
Chinese Journal of Internal Medicine
2011;50(2):116-119
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effectiveness and safety of endoscopic papillary balloon dilation( EPBD ) for the removal of common bile duct stones. Methods Three hundred and twenty consecutive patients with common bile duct stones on endoscopic retrograde cholangiopancreatography (ERCP) who met all eligibility criteria were randomly assigned endoscopic sphincterotomy (EST) or EPBD.Complications were classified by an expert panel unaware of treatment allocation and outcome. Results After a single ERCP, all stones were removed from 112 patients ( 70% ) assigned EST and 104 ( 65% )assigned EPBD. Mechanical lithotripsy was used to fragment stones in 36 (22. 5% ) EPBD procedures and 32 ( 20. 0% ) EST procedures. Early complications occurred in 5.6% EST patients and 8.1% EPBD patients. No patient died. Gallstone disease recurrence, which is a long-term complication, is 7. 5% ( 12/160) in EST patients and 2.5% (4/160) in EPBD patients, P ＜0. 05. Conclusions The success rate of EPBD was similar to that of EST. We found no evidence of previously suggested higher risk of pancreatitis with EPBD, and suggest that EPBD is preferred in patients who are not suitable for EST, such as those with high risk of bleeding. This procedure is a valuable alternative to EST in patients with bile duct stones.
