Clinical analysis of endoscopic papillary muscle incision combined with balloon dilation in the treatment of common bile duct stones in elderly patients

Abstract

Objective To investigate the safety and efficacy of endoscopic duodenal papillary muscle small incision(EST) combined with duodenal papillary balloon dilation(EPBD) in the treatment of elderly patients with bile duct stones. Methods 100 elderly patients with bile duct stones were treated with endoscopic stone removal.Among them, 55 patients were treated with SEST combined with EPBD(EPBD group), 45 patients were treated with a single EST(EST group), the rate of stone removal, the occurrence rate of lithotripsy and the incidence of complications were compared between the two groups. Results The SEST+ EPBD group at a time calculi clearance rate, postoperative hyperamylasemia, post pancreatitis, cholangitis were 98.2%, 7.3% and 3.6%, 1.8%, the EST group were 97.7%, 6.7%, 6.7%, 3.6% and the difference between the two groups had no significant(all P>0.05). The SEST+ EPBD group of gravel formation rate was 3.6%, lower than 13.3% in the EST group, the difference was statistically significant(χ2=9.647, P<0.05). The SEST+ EPBD group had no bleeding, bleeding in EST group incidence rate was 11.1%, the difference was statistically significant(χ2=11.235, P<0.05); The recurrence rate of the SEST+ EPBD group was 1.8%, which was lower than 11.1% in the EST group, the difference was statistically significant(χ2=10.113, P<0.05). Conclusion EST combined with EPBD in the treatment of elderly common bile duct stones is safe and effective, which can significantly reduce the incidence of debris and bleeding, reduce the recurrence rate of common bile duct stones. Key words: Duodenal papillary muscle small incision; Duodenal papillary balloon dilation; Common bile duct stones; Aged