A study on the combined use of small endoscopic sphincterotomy plus balloon dilation to replace endoscopic sphincterotomy in the removal of common duct stones
10.3760/cma.j.issn.1007-8118.2013.06.003
- VernacularTitle:胆总管结石乳头括约肌小切开联合气囊扩张术代替乳头括约肌切开术的可行性研究
- Author:
Guodong LI
;
Qiuping PANG
;
Xiujuan ZHANG
;
Haiyan DONG
;
Rong GUO
;
Hailan ZHAI
;
Xinyong JIA
- Publication Type:Journal Article
- Keywords:
Cholelithiasis;
Sphincterotomy,endoscopic;
Balloon dilation
- From:
Chinese Journal of Hepatobiliary Surgery
2013;(6):411-415
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate whether small endoscopic sphincterotomy (EST) plus balloon dilation (EPBD) can replace endoscopic sphincterotomy (EST) alone for patients with common bile duct (CBD) stones.Methods From May 2008 to April 2011,462 patients with CBD stones were randomly divided into two groups.The success rate of complete stone removal after the first session,the rate of using mechanical lithotripsy (ML),the short-term complications,the procedure time and fluo roscopy time were compared between the two groups.Results Overall ductal clearance did not differ between the two groups (96.5％ vs 93.5％,P＞0.05).The complication rates at 24 hours were 6.9％ for the small EST plus EPBD group and 11.7％ for the EST group (P＞0.05).However,the rate of complete stone removal after the first session using small EST plus EPBD was significantly higher than EST alone (86.2％ vs 70.4％,P＜0.05).ML was required significantly more often in the EST group when compared with the small EST plus EPBD group (34.8％ vs 12.1％,P＜0.05).The total procedure time and total fluoroscopy time in the small EST plus EPBD group were significantly shorter than the EST group [(38.6±15.5) min vs (47.1±20.2) min,P＜0.05 and (17.3± 7.0) min vs (26.5±10.8) min,P＜0.05].Conclusions Compared with EST,small EST plus EPBD was safe and more efficacious for bile duct stones.In the future,small EST plus EPBD probably can replace EST to be the first treatment of choice for bile duct stones.
