Limited endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation for common bile duct stones in elderly patients
10.3760/cma.j.issn.1007-5232.2016.02.008
- VernacularTitle:经内镜乳头括约肌切开术小切开联合内镜下乳头大气囊扩张术治疗老年胆总管结石疗效分析
- Author:
Jingpeng JIN
;
Changfeng LI
;
Zongqiang WANG
;
Kai LI
;
Dandan LI
;
Lei YANG
;
Baogang ZHANG
;
Yang LIU
;
Bin ZHANG
- Publication Type:Journal Article
- Keywords:
Choledocholithiasis;
Minor endoscopic sphincterotomy;
Endoscopic papillary large balloon dilation
- From:
Chinese Journal of Digestive Endoscopy
2016;33(2):97-100
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of minor endoscopic sphincterotomy (EST)with endoscopic papillary large balloon dilation(EPLBD)for common bile duct stones(CBDS)in elderly patients and to study the influence of the periampullary diverticula on efficacy. Methods Data of 209 patients with CBD stones(more than 1. 0 cm)over the age of 70 were retrospectively analyzed. The pa-tients were divided into EST group(103 cases)and the EST with EPLBD group(106 cases),which was further divided into two subgroups with and without periampullary diverticula.Operation time,complete stone removal rate in the first session,mechanical lithotripsy usage rate and complications were compared between the two groups. Results Compared with EST group,the EST with EPLBD group had shorter operation time [(25. 65±8. 76)min VS(35±6. 67)min,P= 0. 000],a higher success rate of the complete stone removal in the first session( 90. 57% VS 83. 50%,P = 0. 030),lower rate of mechanical lithotripsy( 8. 50% VS 55. 34%,P= 0. 000),but with a higher incidence of hyperamylemia(18/ 106 VS 7/ 103,P = 0. 044).The o-verall stone removal rates showed no difference(96. 23% VS 95. 14%,P= 0. 700).In the EPLBD group,di-verticulum had no effects on the results and complications of ERCP( P> 0. 05). Conclusion EST with EPLBD is a safe and effective method for CBDS in elderly patients. Periampullary diverticula does not affect the therapeutic effects of this method.
