Endoscopic papillary large balloon dilation with or without sphincterotomy for extraction of large bile duct stones

Abstract

ObjectivesThis work aimed to evaluate the safety and efficacy of endoscopic papillary large balloon dilatation (EPLBD) with or without endoscopic sphincterotomy (EST) in extraction of large common bile duct stones (CBDSs).BackgroundEST combined with EPLBD has been proposed as an alternative to manage large bile duct stones. However, recent reports indicate that EPLBD alone may be safe and effective in this setting.Patients and methodsFrom July 2019 to December 2021, we prospectively compared EPLBD alone (group I, n=100) with EST+EPLBD (group II, n=100) for the treatment of large CBDSs. CBDS clearance rate, frequency of mechanical lithotripsy usage, total procedure time, and intraendoscopic and postendoscopic complications were analyzed.ResultsStatistical analysis revealed that there were no significant differences between the studied groups regarding the use of mechanical lithotripsy (6 vs. 8%, P=0.579), overall and initial stone clearance rates (92 vs. 88%, P=0.346; and 81 vs. 76%, P=0.389, respectively), procedure-related pancreatitis (3 vs. 1%, P=0.312), or other intraendoscopic and postendoscopic adverse events, but there was a significant difference in terms of total procedure time (41.23±10.6 vs. 36.87±8.06, P=0.001).ConclusionThe therapeutic outcomes and complications of sole EPLBD for the removal of large CBDSs were comparable to those of EPLBD with prior EST.