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A comparison of endoscopic papillary balloon dilation and endoscopic sphincterotomy for the removal of common bile duct stones



A comparison of endoscopic papillary balloon dilation and endoscopic sphincterotomy for the removal of common bile duct stones



Zhonghua Nei Ke Za Zhi 50(2): 116-119



To explore the effectiveness and safety of endoscopic papillary balloon dilation (EPBD) for the removal of common bile duct stones. 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. 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. 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.

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Accession: 051110615

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PMID: 21418830


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